# ALEXANDER DENTAL GROUOP CHTD.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356514772
- **Authorized official:** JEANETTE SHARP (OFFICE MANAGER)
- **Authorized official phone:** (208) 733-7566

## Contact information

- **Practice address:** 506 HANSEN ST E, TWIN FALLS, ID 83301-6254
- **Practice address phone:** (208) 733-7566
- **Practice address fax:** (208) 734-4267
- **Mailing address:** 506 HANSEN ST E, TWIN FALLS, ID 83301-6254
- **Mailing address phone:** (208) 733-7566
- **Mailing address fax:** (208) 734-4267

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/07/2008
- **Last updated:** 04/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 181859 | IDAHO SMILES | ID |