Provider Demographics
NPI:1528104445
Name:DR ALEXANDER N MASTERS DR SOPHIA P MASTERS AND ASSOC PC
Entity type:Organization
Organization Name:DR ALEXANDER N MASTERS DR SOPHIA P MASTERS AND ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:N
Authorized Official - Last Name:MASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-463-8635
Mailing Address - Street 1:37546 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036
Mailing Address - Country:US
Mailing Address - Phone:586-463-8635
Mailing Address - Fax:586-463-8622
Practice Address - Street 1:37546 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036
Practice Address - Country:US
Practice Address - Phone:586-463-8635
Practice Address - Fax:586-463-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty