Provider Demographics
NPI:1982164117
Name:ALEXANDER DENTAL CREATIONS PLLC
Entity Type:Organization
Organization Name:ALEXANDER DENTAL CREATIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-882-3330
Mailing Address - Street 1:21188 E OCOTILLO RD STE 101
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4942
Mailing Address - Country:US
Mailing Address - Phone:480-882-3330
Mailing Address - Fax:
Practice Address - Street 1:21188 E OCOTILLO RD STE 101
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-4942
Practice Address - Country:US
Practice Address - Phone:480-882-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental