Provider Demographics
NPI:1427171263
Name:ALEXANDER, GERALD D (DMD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:D
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 YORK ST
Mailing Address - Street 2:CROWN COURT
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5608
Mailing Address - Country:US
Mailing Address - Phone:203-782-0677
Mailing Address - Fax:203-776-9760
Practice Address - Street 1:129 YORK ST
Practice Address - Street 2:CROWN COURT
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5608
Practice Address - Country:US
Practice Address - Phone:203-782-0677
Practice Address - Fax:203-776-9760
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4721122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist