Most Relevant Information
Provider Data
| NPI Number: | 1003478959 |
| Provider Name: | ALEXANDRA PERICOLOSI DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 2901600567 |
Most Important Dates
| Enumeration Date: | 07/01/2019 |
| Last Updated: | 10/28/2024 |
Provider Practice Location
325 E H ST
IRON MOUNTAIN
MI
498014760
Practice Location Phone/Fax
| Phone: | 9067743300 |
| Fax: |
Provider Mailing Location
325 E H ST
IRON MOUNTAIN
MI
498014760
Provider Mailing Phone/Fax
| Phone: | 9067743300 |
| Fax: |