Provider Demographics
NPI:1467759456
Name:SHEETS, ALLEN KEITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:KEITH
Last Name:SHEETS
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 1:722 SECOND AVENUE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631
Mailing Address - Country:US
Mailing Address - Phone:740-446-3999
Mailing Address - Fax:740-446-4703
Practice Address - Street 1:722 SECOND AVENUE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631
Practice Address - Country:US
Practice Address - Phone:740-446-3999
Practice Address - Fax:740-446-4703
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH131531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice