Provider Demographics
NPI:1417285966
Name:ALONSO, AURELIO A (DDS, MS, PHD)
Entity type:Individual
Prefix:DR
First Name:AURELIO
Middle Name:A
Last Name:ALONSO
Suffix:
Gender:M
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10207 CERNY ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4879
Mailing Address - Country:US
Mailing Address - Phone:919-660-9000
Mailing Address - Fax:919-576-8811
Practice Address - Street 1:10207 CERNY STREET
Practice Address - Street 2:SUITE 114
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617
Practice Address - Country:UM
Practice Address - Phone:919-660-9000
Practice Address - Fax:919-576-8811
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00177122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist