Provider Demographics
NPI:1376889485
Name:ANNA ALLER DMD, PA
Entity Type:Organization
Organization Name:ANNA ALLER DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-655-0123
Mailing Address - Street 1:555 BILTMORE WAY
Mailing Address - Street 2:#105
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5757
Mailing Address - Country:US
Mailing Address - Phone:305-569-9966
Mailing Address - Fax:
Practice Address - Street 1:555 BILTMORE WAY
Practice Address - Street 2:#105
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5757
Practice Address - Country:US
Practice Address - Phone:305-569-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN199501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty