| Allen Dental Practice | |
|
138 Country Club Ct Tarpon Springs FL 34689-3704 | |
| (727) 937-5159 | |
| (727) 937-5109 |
| Full Name | Allen Dental Practice |
|---|---|
| Speciality | Dentist |
| Location | 138 Country Club Ct, Tarpon Springs, Florida |
| Authorized Official Name and Position | Hayden Park Allen (LLC MANAGER) |
| Authorized Official Contact | 7279375159 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Allen Dental Practice 138 Country Club Ct Tarpon Springs FL 34689-3704 Ph: (727) 937-5159 | Allen Dental Practice 138 Country Club Ct Tarpon Springs FL 34689-3704 Ph: (727) 937-5159 |
| NPI Number | 1902056161 |
|---|---|
| Provider Enumeration Date | 09/24/2008 |
| Last Update Date | 09/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902056161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5617 (Florida) | Primary |
| 122300000X | Dentist | 14250 (Florida) | Secondary |
| 122300000X | Dentist | 17222 (Florida) | Secondary |
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