Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 6645 | NC |
NPI | 1285710350 |
---|---|
Provider Name | Donna Denise Alexander |
First Address | Huntersville, NC 28078-6684 |
Second Address | Mooresville, NC 28117-9500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 05/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5902068 | (05) | NC |