MEDICARE: ALEXANDRA NICOLE WEXLER D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	10379	NC

General Provider Information

NPI Number	:	1356896450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA NICOLE WEXLER D.M.D.

Provider Business Mailing Address
First Line	:	6307 PENUCHE WAY
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3356
Country	:	US
Telephone Number	:	206-595-4142
Fax Number	:

Provider Business Practice Location Address
First Line	:	2733 HORSE PEN CREEK RD
Second Line	:	#107
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8399
Country	:	US
Telephone Number	:	336-854-9270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2016
Last Update Date	:	08/24/2016

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