Healthcare Provider Details

I. General information

NPI: 1245145945
Provider Name (Legal Business Name): ALLENCRANE, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 N GATEWAY DR STE 1
PROVIDENCE UT
84332-6102
US

IV. Provider business mailing address

65 N GATEWAY DR STE 1
PROVIDENCE UT
84332-6102
US

V. Phone/Fax

Practice location:
  • Phone: 435-787-2223
  • Fax:
Mailing address:
  • Phone: 435-787-2223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: STANTON CANNON ALLEN
Title or Position: OWNER
Credential: DDS
Phone: 435-787-2223