| NPI | 1972735611 |
|---|---|
| Former Name | TIFFANY IRIS ALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 21023) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 054549) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2014-12-09 |