Provider Demographics
NPI:1417516311
Name:ALLEN, BRITTON NICOLE (DMD)
Entity Type:Individual
Prefix:
First Name:BRITTON
Middle Name:NICOLE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9931 HYATT RESORT DR APT 1518
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4179
Mailing Address - Country:US
Mailing Address - Phone:702-349-0720
Mailing Address - Fax:
Practice Address - Street 1:810 S GENERAL MCMULLEN DR STE 108
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-3163
Practice Address - Country:US
Practice Address - Phone:210-485-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX351021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice