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General NPI Number Information
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NPI Number | 1063301786
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Entity Type | Individual
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Provider Name | ALEXA NICOLE STYLIANAKIS DMD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 703 E MOODY BLVD
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City | BUNNELL
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State | FL
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Zip | 32110-5907
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Country | US
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Telephone | 386-437-3091
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Fax |
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Provider Business Mailing Address
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Address Line | 27 WILLOW ST
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City | PALM COAST
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State | FL
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Zip | 32164-7225
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Country | US
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Telephone | 904-742-7872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30569
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License Number State | FL
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