Healthcare Provider Details

I. General information

NPI: 1023042967
Provider Name (Legal Business Name): CLEARWATER DENTAL ASSOCIATES PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2226 DRUID ROAD E
CLEARWATER FL
33764
US

IV. Provider business mailing address

2226 DRUID ROAD E
CLEARWATER FL
33764
US

V. Phone/Fax

Practice location:
  • Phone: 727-797-8800
  • Fax: 727-791-3820
Mailing address:
  • Phone: 727-797-8800
  • Fax: 727-791-3820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. NOLAN W ALLEN
Title or Position: OWNER
Credential: DDS
Phone: 727-797-8800