Provider Demographics
NPI:1851517452
Name:A. LANOY ALSTON
Entity Type:Organization
Organization Name:A. LANOY ALSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LANOY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:520-886-8503
Mailing Address - Street 1:1160 N PANTANO RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5126
Mailing Address - Country:US
Mailing Address - Phone:520-886-8503
Mailing Address - Fax:520-225-6660
Practice Address - Street 1:1160 N PANTANO RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5126
Practice Address - Country:US
Practice Address - Phone:520-886-8503
Practice Address - Fax:520-225-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0076509122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty