Provider Demographics
NPI:1093185878
Name:ALLEN, STANLEY JR (DDS)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2783 NC HIGHWAY 68 S
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8324
Mailing Address - Country:US
Mailing Address - Phone:336-841-0000
Mailing Address - Fax:
Practice Address - Street 1:2783 NC HIGHWAY 68 S
Practice Address - Street 2:SUITE 107
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8324
Practice Address - Country:US
Practice Address - Phone:336-841-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC41641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice