Provider Demographics
NPI:1053632455
Name:WILLIAM G ALLEN PLLC
Entity Type:Organization
Organization Name:WILLIAM G ALLEN PLLC
Other - Org Name:DISCOVERY SMILES DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-721-2000
Mailing Address - Street 1:150 S HOUGHTON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-6704
Mailing Address - Country:US
Mailing Address - Phone:520-721-2000
Mailing Address - Fax:520-721-2014
Practice Address - Street 1:150 S HOUGHTON RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-6704
Practice Address - Country:US
Practice Address - Phone:520-721-2000
Practice Address - Fax:520-721-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-20
Last Update Date:2010-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2849122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty