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General NPI Number Information
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NPI Number | 1679055271
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Entity Type | Individual
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Provider Name | SHEILA ALLEN
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Gender | Female
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 705 HUDSON AVE
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City | ASHBURN
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State | GA
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Zip | 31714-5312
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Country | US
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Telephone | 229-567-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 16935 ADEL HWY
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City | BARNEY
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State | GA
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Zip | 31625-2126
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Country | US
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Telephone | 229-200-8888
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH012280
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License Number State | GA
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