Provider Demographics
NPI:1013152016
Name:DE LA CRUZ, ALEJANDRO (DDS)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:DE LA CRUZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7380 BIRD RD STE B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6634
Mailing Address - Country:US
Mailing Address - Phone:305-441-2773
Mailing Address - Fax:305-266-1529
Practice Address - Street 1:7380 BIRD RD STE B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6634
Practice Address - Country:US
Practice Address - Phone:305-441-2773
Practice Address - Fax:305-266-1529
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 145601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice