Provider Demographics
NPI:1629721782
Name:SUNRAY FAMILY DENTISTRY PLLC
Entity Type:Organization
Organization Name:SUNRAY FAMILY DENTISTRY PLLC
Other - Org Name:SUNRAY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:347-520-0318
Mailing Address - Street 1:10725 N LOOP DR STE 104
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:TX
Mailing Address - Zip Code:79927-4627
Mailing Address - Country:US
Mailing Address - Phone:347-520-0318
Mailing Address - Fax:
Practice Address - Street 1:10725 N LOOP DR STE 104
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:TX
Practice Address - Zip Code:79927-4627
Practice Address - Country:US
Practice Address - Phone:347-520-0318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-29
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty