Provider Demographics
NPI:1336364512
Name:ALPHA DENTAL GROUP, P.C.
Entity Type:Organization
Organization Name:ALPHA DENTAL GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YUNNING
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-265-0788
Mailing Address - Street 1:341 N COLONY ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3170
Mailing Address - Country:US
Mailing Address - Phone:203-265-0788
Mailing Address - Fax:
Practice Address - Street 1:341 N COLONY ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-3170
Practice Address - Country:US
Practice Address - Phone:203-265-0788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-14
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT008759122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty