Provider Demographics
NPI:1770632861
Name:P. ALEXANDER BOLLENDORF, D.M.D., P.A.
Entity Type:Organization
Organization Name:P. ALEXANDER BOLLENDORF, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:BOLLENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-772-7030
Mailing Address - Street 1:607 BENSON RD STE A
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-3988
Mailing Address - Country:US
Mailing Address - Phone:919-772-7030
Mailing Address - Fax:
Practice Address - Street 1:607 BENSON RD STE A
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3988
Practice Address - Country:US
Practice Address - Phone:919-772-7030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC90198OtherBLUE CROSS