Provider Demographics
NPI:1467577171
Name:ALLEN, HAROLD EDDIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:EDDIE
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6912 E RENO AVE
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-2162
Mailing Address - Country:US
Mailing Address - Phone:405-732-2214
Mailing Address - Fax:405-732-0705
Practice Address - Street 1:6912 E RENO AVE
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-2162
Practice Address - Country:US
Practice Address - Phone:405-732-2214
Practice Address - Fax:405-732-0705
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3139122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist