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NPI Code Detail

MEDICARE: DR. HEATHER ALLEN D.D.S.

MEDICARE:  DR. HEATHER  ALLEN  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry10982GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073608410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEATHER ALLEN D.D.S.
Provider Business Mailing Address
First Line : 1234 S. HAIRSTON ROAD
Second Line : SUITE 23
City : STONE MOUNTAIN
State : GA
Zip : 30088
Country : US
Telephone Number : 404-294-3600
Fax Number : 404-294-9880
Provider Business Practice Location Address
First Line : 1234 S. HAIRSTON ROAD
Second Line : SUITE 23
City : STONE MOUNTAIN
State : GA
Zip : 30088
Country : US
Telephone Number : 404-294-3600
Fax Number : 404-294-9880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 07/08/2007

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Directions to “ DR. HEATHER ALLEN D.D.S.” Practice Location

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