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General NPI Number Information
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NPI Number | 1467649681
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Entity Type | Organization
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Legal Business Name | STANLEY L ALLEN DDS,PA
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 706 SUMMIT AVE
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City | GREENSBORO
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State | NC
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Zip | 27405-7832
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Country | US
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Telephone | 336-378-1150
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Fax | 336-273-7110
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Provider Business Mailing Address
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Address Line | PO BOX 21754
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City | GREENSBORO
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State | NC
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Zip | 27420-1754
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Country | US
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Telephone | 336-378-1150
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Fax | 336-273-7110
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Authorized Official
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Title or Position | OFFICE MGR.
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Name | MRS. YVONNE ALLEN
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Credential |
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Telephone | 336-378-1150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4164
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License Number State | NC
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