Provider Demographics
NPI:1043925886
Name:MAGNOLIA DENTISTRY PLLC
Entity type:Organization
Organization Name:MAGNOLIA DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEURY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-368-4646
Mailing Address - Street 1:245 SOUTHPOINT DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-4756
Mailing Address - Country:US
Mailing Address - Phone:859-368-4646
Mailing Address - Fax:
Practice Address - Street 1:111 BETHEL HARVEST DR
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356
Practice Address - Country:US
Practice Address - Phone:859-800-8090
Practice Address - Fax:859-810-6681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental