| NPI | 1902056161 |
|---|---|
| Doing Business As | ALLEN DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | HAYDEN PARK ALLEN LLC Manager 727-937-5159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 5617) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 14250) |
| 122300000X Dentist (Licence: FL 17222) | |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-09-24 |