MEDICARE: ROSS P ALLEN DDS PLLC

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
1	122300000X	Dentist	6019	OK

General Provider Information

NPI Number	:	1912202730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSS P ALLEN DDS PLLC

Provider Business Mailing Address
First Line	:	8383 S PENN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-5249
Country	:	US
Telephone Number	:	405-686-7970
Fax Number	:	405-686-7909

Provider Business Practice Location Address
First Line	:	8383 S PENN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-5249
Country	:	US
Telephone Number	:	405-686-7970
Fax Number	:	405-686-7909

Authorized Official
Title or Position	:	DENTIST/MANAGER
Name	:	DR. ROSS P ALLEN
Credential	:	DDS
Telephone Number	:	405-630-4667

Provider Enumeration Date	:	01/26/2011
Last Update Date	:	01/26/2011

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