Individual
ALEXANDER DONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1502 N PINE ST STE 2, LA GRANDE, OR 97850-3543
(541) 963-8585
Mailing address
1502 N PINE ST STE 2, LA GRANDE, OR 97850-3543
(541) 963-8585
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D-4941
ID
122300000X
Dentist
Primary
D11161
OR
Other
Enumeration date
06/28/2018
Last updated
10/15/2019
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