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General NPI Number Information
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NPI Number | 1164230306
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Entity Type | Organization
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Legal Business Name | ALEJANDRO DENTAL GROUP CORPORATION
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 18856 AMAR RD STE 15
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City | WALNUT
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State | CA
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Zip | 91789-7104
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Country | US
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Telephone | 626-941-4526
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Fax |
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Provider Business Mailing Address
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Address Line | 6755 PATTERSON WAY
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City | PALMDALE
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State | CA
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Zip | 93552-4150
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Country | US
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Telephone | 626-941-4526
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | LOURDES ALEJANDRO
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Credential | DDS
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Telephone | 626-941-4526
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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 |
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License Number State |
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