Provider Demographics
NPI:1275718124
Name:PEARSON, ALLEN IGOROVICH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:IGOROVICH
Last Name:PEARSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:520 W BROWN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-5815
Mailing Address - Country:US
Mailing Address - Phone:972-429-7070
Mailing Address - Fax:972-429-7071
Practice Address - Street 1:520 W BROWN ST
Practice Address - Street 2:SUITE B
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-5815
Practice Address - Country:US
Practice Address - Phone:972-429-7070
Practice Address - Fax:972-429-7071
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX210361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry