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General NPI Number Information
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NPI Number | 1003430570
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Entity Type | Organization
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Legal Business Name | ALLEN DENTAL, PLLC
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Dates
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Enumeration Date | 06/01/2020
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 15 1ST ST NE STE 207151
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City | CHOTEAU
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State | MT
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Zip | 59422-9275
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Country | US
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Telephone | 406-466-5662
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Fax | 406-466-5861
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Provider Business Mailing Address
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Address Line | 15 1ST ST NE STE 207151
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City | CHOTEAU
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State | MT
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Zip | 59422-9275
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Country | US
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Telephone | 406-466-5662
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Fax | 406-466-5861
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Authorized Official
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Title or Position | FINANCIAL COORDINATOR
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Name | MARTHA A COOPER
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Credential |
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Telephone | 907-947-7193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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