# ALLA ALEXIS SHRAGER DMD 4 PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Dental Group, Southern Dental Group, Lake Gaston Dental - Warrenton
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033992599
- **Authorized official:** DR. ALLA ALLA SHRAGER DMD (PRESIDENT)
- **Authorized official phone:** (412) 720-9277

## Contact information

- **Practice address:** 8331 BANDFORD WAY STE 105, RALEIGH, NC 27615-2765
- **Practice address phone:** (919) 636-5200
- **Mailing address:** 8331 BANDFORD WAY STE 105, RALEIGH, NC 27615-2765
- **Mailing address phone:** (919) 636-5200
- **Mailing address fax:** (919) 847-7391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 08/17/2023
- **Last updated:** 01/13/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12355 | DENTAL | NC |