Healthcare Provider Details
I. General information
NPI: 1780069419
Provider Name (Legal Business Name): ALLISON L BIEHLE D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/23/2015
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1811 DOGWOOD DR
KOKOMO IN
46902-5738
US
IV. Provider business mailing address
2525 SOLANA WAY #108
INDIANAPOLIS IN
46240-6002
US
V. Phone/Fax
- Phone: 765-457-4000
- Fax: 765-457-4060
- Phone: 812-525-3705
- Fax: 765-457-4060
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 12012387A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: