Provider Demographics
NPI:1265938914
Name:DRS. PATEL, ALSTON AND ASSOCIATES PA
Entity type:Organization
Organization Name:DRS. PATEL, ALSTON AND ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-461-0685
Mailing Address - Street 1:1230 MANN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5535
Mailing Address - Country:US
Mailing Address - Phone:704-461-0685
Mailing Address - Fax:704-461-0684
Practice Address - Street 1:1230 MANN DR STE 100
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5535
Practice Address - Country:US
Practice Address - Phone:704-461-0685
Practice Address - Fax:704-461-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6497261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental