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General NPI Number Information
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NPI Number | 1891723904
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Entity Type | Individual
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Provider Name | ALLYN J COLEMAN DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | ALEXANDRIA VA HEALTH CARE SYSTEM 2495 SHREVEPORT HIGHWAY
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City | PINEVILLE
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State | LA
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Zip | 71360-4044
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Country | US
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Telephone | 318-473-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 1354 S 117TH ST
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City | WEST ALLIS
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State | WI
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Zip | 53214-2127
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Country | US
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Telephone | 414-258-0281
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 046124
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License Number State | NY
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