MEDICARE: DR. JOHN CHARLES ALEXANDER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	24941	CA

General Provider Information

NPI Number	:	1023108396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CHARLES ALEXANDER DDS

Provider Business Mailing Address
First Line	:	3619 UNION AVE
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93305-2939
Country	:	US
Telephone Number	:	661-323-1248
Fax Number	:	661-323-1399

Provider Business Practice Location Address
First Line	:	3619 UNION AVE
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93305-2939
Country	:	US
Telephone Number	:	661-323-1248
Fax Number	:	661-323-1399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2006
Last Update Date	:	07/08/2007

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