Provider Demographics
NPI:1922028000
Name:ALSTON, TERESITA LARONCE (DMD)
Entity type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:LARONCE
Last Name:ALSTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47149 BUSE RD BUILDING 1370
Mailing Address - Street 2:COMMAND SUITE
Mailing Address - City:PATUXENT RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:20670
Mailing Address - Country:US
Mailing Address - Phone:301-342-1419
Mailing Address - Fax:
Practice Address - Street 1:47149 BUSE RD BUILDING 1370
Practice Address - Street 2:COMMAND SUITE
Practice Address - City:PATUXENT RIVER
Practice Address - State:MD
Practice Address - Zip Code:20670
Practice Address - Country:US
Practice Address - Phone:301-342-1419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42201223G0001X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice