Provider Demographics
NPI:1205232295
Name:ALLAN L LINK DMD & ASSOCIATES LLC
Entity Type:Organization
Organization Name:ALLAN L LINK DMD & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:LENNOX
Authorized Official - Last Name:LINK
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:314-540-0658
Mailing Address - Street 1:14335 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4048
Mailing Address - Country:US
Mailing Address - Phone:314-894-9711
Mailing Address - Fax:314-894-3980
Practice Address - Street 1:14335 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-4048
Practice Address - Country:US
Practice Address - Phone:636-496-8584
Practice Address - Fax:314-894-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO135641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty