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NPI Code Detail

MEDICARE: DR. KENNETH BILLINGS ALLEN D.D.S.

MEDICARE:  DR. KENNETH BILLINGS ALLEN  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1067WY
21223G0001XGeneral Practice Dentistry8155CO

General Provider Information

NPI Number : 1104829118
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH BILLINGS ALLEN D.D.S.
Provider Business Mailing Address
First Line : 2117 CUSTER DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-3684
Country : US
Telephone Number : 970-221-3700
Fax Number : 970-482-7549
Provider Business Practice Location Address
First Line : 1337 RIVERSIDE AVE
Second Line : STE 1
City : FORT COLLINS
State : CO
Zip : 80524-4373
Country : US
Telephone Number : 970-221-1658
Fax Number : 970-482-7549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 10/26/2021

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Directions to “ DR. KENNETH BILLINGS ALLEN D.D.S.” Practice Location

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