Provider Demographics
NPI:1982146403
Name:CRISTINA ALARCON DDS, LLC
Entity Type:Organization
Organization Name:CRISTINA ALARCON DDS, LLC
Other - Org Name:FAVORITE SMILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CRISTINA
Authorized Official - Last Name:ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:443-846-0130
Mailing Address - Street 1:2721 HARRIS LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3860
Mailing Address - Country:US
Mailing Address - Phone:410-693-2779
Mailing Address - Fax:
Practice Address - Street 1:8600 LASALLE RD, YORK BUILDING
Practice Address - Street 2:SUITE 500
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:443-846-0130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD143711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD002072900Medicaid