Provider Demographics
NPI:1427013960
Name:DANIEL A ALLEN DDS PC
Entity Type:Organization
Organization Name:DANIEL A ALLEN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ARD
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-978-0200
Mailing Address - Street 1:4025 WEST BELL ROAD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053
Mailing Address - Country:US
Mailing Address - Phone:602-978-0200
Mailing Address - Fax:602-978-3162
Practice Address - Street 1:4025 WEST BELL ROAD
Practice Address - Street 2:SUITE 13
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053
Practice Address - Country:US
Practice Address - Phone:602-978-0200
Practice Address - Fax:602-978-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5239122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty