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General NPI Number Information
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NPI Number | 1033384326
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Entity Type | Organization
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Legal Business Name | ALEXANDER R. MCGEOCH, DDS, APC
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 1870 N HIGH ST
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City | LAKEPORT
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State | CA
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Zip | 95453-3615
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Country | US
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Telephone | 707-263-5427
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Fax | 707-263-3925
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Provider Business Mailing Address
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Address Line | 1870 N HIGH ST
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City | LAKEPORT
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State | CA
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Zip | 95453-3615
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Country | US
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Telephone | 707-263-5427
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Fax | 707-263-3925
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ALEXANDER R. MCGEOCH
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Credential | DDS
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Telephone | 707-263-5427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 29368
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License Number State | CA
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