Healthcare Provider Details

I. General information

NPI: 1497725766
Provider Name (Legal Business Name): TERRENCE L ALLEMANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1487 W MAIN ST
TIPP CITY OH
45371-2803
US

IV. Provider business mailing address

1487 W MAIN ST
TIPP CITY OH
45371-2803
US

V. Phone/Fax

Practice location:
  • Phone: 937-667-0776
  • Fax: 937-667-0854
Mailing address:
  • Phone: 937-667-0776
  • Fax: 937-667-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30016164
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: