Provider Demographics
NPI:1154151678
Name:SUNRAY FAMILY DENTISTRY CENTRAL PLLC
Entity type:Organization
Organization Name:SUNRAY FAMILY DENTISTRY CENTRAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:347-520-0318
Mailing Address - Street 1:4329 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-4610
Mailing Address - Country:US
Mailing Address - Phone:915-320-1800
Mailing Address - Fax:915-320-1801
Practice Address - Street 1:4329 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4610
Practice Address - Country:US
Practice Address - Phone:915-320-1800
Practice Address - Fax:915-320-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental