MEDICARE: TERRENCE L. ALLEMANG, DDS INC.

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
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	30016164	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000264404	OTHER	OH	ABCBS PROVIDER #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730246000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRENCE L. ALLEMANG, DDS INC.

Provider Business Mailing Address
First Line	:	1487 W MAIN ST
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-2803
Country	:	US
Telephone Number	:	937-667-0776
Fax Number	:	937-667-0854

Provider Business Practice Location Address
First Line	:	1487 W MAIN ST
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-2803
Country	:	US
Telephone Number	:	937-667-0776
Fax Number	:	937-667-0854

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TERRENCE L ALLEMANG
Credential	:	DDS
Telephone Number	:	937-667-0776

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	08/22/2020

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