Provider Demographics
NPI:1376727982
Name:W. HEATH ALLEN JR. DDS
Entity Type:Organization
Organization Name:W. HEATH ALLEN JR. DDS
Other - Org Name:CARING FOR KIDS AND PARENTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HEATH
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-695-2575
Mailing Address - Street 1:6882 MAIN STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061
Mailing Address - Country:US
Mailing Address - Phone:804-695-2575
Mailing Address - Fax:804-695-2815
Practice Address - Street 1:6882 MAIN STREET
Practice Address - Street 2:A
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061
Practice Address - Country:US
Practice Address - Phone:804-695-2575
Practice Address - Fax:807-469-5281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA40451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty