Provider Demographics
NPI:1740981414
Name:MAAL, ALEXANDER JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JOSEPH
Last Name:MAAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 KODIAK WAY
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5548
Mailing Address - Country:US
Mailing Address - Phone:603-508-9967
Mailing Address - Fax:
Practice Address - Street 1:75 CLINTON ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2310
Practice Address - Country:US
Practice Address - Phone:603-686-8013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18600531223G0001X
390200000X
NH048331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program