Provider Demographics
NPI:1376038604
Name:COLLEEN S. ALLEN, D.D.S., PLLC
Entity Type:Organization
Organization Name:COLLEEN S. ALLEN, D.D.S., PLLC
Other - Org Name:AUTUMN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-444-5968
Mailing Address - Street 1:685 BLYTHE STREET CT STE A
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4167
Mailing Address - Country:US
Mailing Address - Phone:828-697-6000
Mailing Address - Fax:828-697-6003
Practice Address - Street 1:685 BLYTHE STREET CT STE A
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4167
Practice Address - Country:US
Practice Address - Phone:828-697-6000
Practice Address - Fax:828-697-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental