Provider Demographics
NPI:1134517477
Name:STEVEN ALEXANDER DDS, MSD, P.C.
Entity type:Organization
Organization Name:STEVEN ALEXANDER DDS, MSD, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:518-793-8511
Mailing Address - Street 1:333 AVIATION RD BLDG A
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-2915
Mailing Address - Country:US
Mailing Address - Phone:518-793-8511
Mailing Address - Fax:518-793-8588
Practice Address - Street 1:333 AVIATION RD BLDG A
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-2915
Practice Address - Country:US
Practice Address - Phone:518-793-8511
Practice Address - Fax:518-793-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057600-11223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty