Healthcare Provider Details

I. General information

NPI: 1649424979
Provider Name (Legal Business Name): KRISTEN M ALEXANDER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 MAIN STREET KRISTEN M. ALEXANDER
CLARENCE NY
14031
US

IV. Provider business mailing address

1077 DELAWARE ROAD KRISTEN M. ALEXANDER
BUFFALO NY
14223
US

V. Phone/Fax

Practice location:
  • Phone: 716-759-8323
  • Fax: 716-759-0935
Mailing address:
  • Phone: 716-875-0405
  • Fax: 716-875-9620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number053374
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: