Provider Demographics
NPI:1710211628
Name:ALEX G PAPPAS, DDS, PLLC
Entity Type:Organization
Organization Name:ALEX G PAPPAS, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:G
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-871-7083
Mailing Address - Street 1:393 FRANKLIN AVE
Mailing Address - Street 2:SUITE #103
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1222
Mailing Address - Country:US
Mailing Address - Phone:516-354-5228
Mailing Address - Fax:516-354-8006
Practice Address - Street 1:393 FRANKLIN AVE
Practice Address - Street 2:SUITE #103
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1222
Practice Address - Country:US
Practice Address - Phone:516-354-5228
Practice Address - Fax:516-354-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0531091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty