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NPI Code Detail

MEDICARE: DR. AMANDA ASHLEY ALLEN DDS

MEDICARE: DR. AMANDA ASHLEY ALLEN DDS
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
11223P0221XPediatric Dentistry8565NC
2122300000XDentist8565NC

General Provider Information

NPI Number : 1750543484
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDA ASHLEY ALLEN DDS
Provider Business Mailing Address
First Line : 1111 S POLLOCK ST
Second Line :
City : SELMA
State : NC
Zip : 27576-2933
Country : US
Telephone Number : 919-965-2552
Fax Number :
Provider Business Practice Location Address
First Line : 1111 S POLLOCK ST
Second Line :
City : SELMA
State : NC
Zip : 27576-2933
Country : US
Telephone Number : 919-570-0180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2008
Last Update Date : 05/03/2024

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Directions to “ DR. AMANDA ASHLEY ALLEN DDS” Practice Location

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