Individual
DR. THERESA ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1005 E LASALLE AVE, SOUTH BEND, IN 46617-2818
(574) 245-7503
(574) 245-7502
Mailing address
1005 E LASALLE AVE, SOUTH BEND, IN 46617-2818
(574) 245-7503
(574) 245-7502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009924
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12009924
INDIANA LISCENSE
IN
Enumeration date
07/19/2006
Last updated
03/18/2019
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