Provider Demographics
NPI:1679103899
Name:MARIA T ALARCON DDS DENTAL CORPORATION
Entity type:Organization
Organization Name:MARIA T ALARCON DDS DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-325-8810
Mailing Address - Street 1:315 40TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-2217
Mailing Address - Country:US
Mailing Address - Phone:510-232-4003
Mailing Address - Fax:
Practice Address - Street 1:315 40TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-2217
Practice Address - Country:US
Practice Address - Phone:510-232-4003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIA T RODRIGUEZ DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-16
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Multi-Specialty