Provider Demographics
NPI:1285896332
Name:HIGH, ALEX (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:HIGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 MOUNT DE CHANTAL RD
Mailing Address - Street 2:STE 3
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6332
Mailing Address - Country:US
Mailing Address - Phone:304-243-5555
Mailing Address - Fax:304-243-9031
Practice Address - Street 1:1203 MOUNT DE CHANTAL RD
Practice Address - Street 2:STE 3
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6332
Practice Address - Country:US
Practice Address - Phone:304-243-5555
Practice Address - Fax:304-243-9031
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810011708Medicaid