Provider Demographics
NPI:1982765897
Name:D ALLESANDRO, PETER JOHN (DDS)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:JOHN
Last Name:D ALLESANDRO
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 1:1522 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910
Mailing Address - Country:US
Mailing Address - Phone:401-467-6363
Mailing Address - Fax:401-467-7613
Practice Address - Street 1:1522 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910
Practice Address - Country:US
Practice Address - Phone:401-467-6363
Practice Address - Fax:401-467-7613
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2584122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist