Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 0442000308 | VA |
NPI | 1003336223 |
---|---|
Provider Name | Dr. Christopher Ian Alexander |
First Address | Glen Allen, VA 23060-6491 |
Second Address | Richmond, VA 23230-1729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2017 |
Last Update Date | 20/06/2017 |