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General NPI Number Information
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NPI Number | 1053562413
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Entity Type | Individual
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Provider Name | ALLEN RICHARD RAPOLLA II D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 2217 IVAN ST APT 1111
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City | DALLAS
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State | TX
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Zip | 75201-7041
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Country | US
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Telephone | 858-442-5536
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Fax |
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Provider Business Mailing Address
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Address Line | 2731 W NORTHWEST HWY STE 104
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City | DALLAS
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State | TX
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Zip | 75220-4782
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Country | US
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Telephone | 972-438-5444
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Fax | 972-438-2540
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 24197
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 24197
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License Number State | TX
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