Healthcare Provider Details
I. General information
NPI: 1730697731
Provider Name (Legal Business Name): ALEXANDER D PAUL DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2018
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8390 W FLAGLER STREET SUITE 210
MIAMI FL
33144
US
IV. Provider business mailing address
8390 W FLAGLER STREET SUITE 210
MIAMI FL
33144
US
V. Phone/Fax
- Phone: 305-209-3642
- Fax:
- Phone: 305-209-3642
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALEXANDER
DOUGLAS
PAUL
Title or Position: ENDODONTIST
Credential: DMD
Phone: 978-424-3068