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General NPI Number Information
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NPI Number | 1073785093
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Entity Type | Organization
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Legal Business Name | RODRICK ALSTON II, DDS, PA
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 03/31/2008
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Provider Practice Location Address
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Address Line | 9201 LEESVILLE RD SUITE 101
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City | RALEIGH
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State | NC
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Zip | 27613-7540
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Country | US
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Telephone | 919-844-2250
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Fax | 919-844-2251
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Provider Business Mailing Address
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Address Line | 9201 LEESVILLE RD SUITE 101
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City | RALEIGH
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State | NC
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Zip | 27613-7540
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Country | US
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Telephone | 919-844-2250
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Fax | 919-844-2251
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Authorized Official
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Title or Position | OWNER
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Name | DR. RODRICK ANDREW ALSTON II
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Credential | DDS
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Telephone | 919-844-2250
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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 | 6647
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License Number State | NC
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