Provider Demographics
NPI:1194209650
Name:ALLEN, ANSLEY PARNELL (DMD)
Entity Type:Individual
Prefix:MRS
First Name:ANSLEY
Middle Name:PARNELL
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 HIGHWAY 78 EAST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501
Mailing Address - Country:US
Mailing Address - Phone:205-387-8888
Mailing Address - Fax:205-221-5142
Practice Address - Street 1:1208 HIGHWAY 78 EAST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501
Practice Address - Country:US
Practice Address - Phone:205-387-8888
Practice Address - Fax:205-221-5142
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL65721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice