Provider Demographics
NPI:1720857063
Name:ALVEY & SOBIN INDIAN TRAIL PLLC
Entity Type:Organization
Organization Name:ALVEY & SOBIN INDIAN TRAIL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-627-1906
Mailing Address - Street 1:6611 OLD MONROE RD
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-5352
Mailing Address - Country:US
Mailing Address - Phone:704-218-2132
Mailing Address - Fax:
Practice Address - Street 1:6611 OLD MONROE RD
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5352
Practice Address - Country:US
Practice Address - Phone:704-218-2132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty