Provider Demographics
NPI:1013438381
Name:HAN, ALEXANDER W (DMD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:W
Last Name:HAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 10TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-5027
Mailing Address - Country:US
Mailing Address - Phone:575-439-5439
Mailing Address - Fax:
Practice Address - Street 1:1713 10TH ST STE A
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5027
Practice Address - Country:US
Practice Address - Phone:575-439-5439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD47291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice