Provider Demographics
NPI:1538484662
Name:ALLEN, CHAD (DDS)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
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 1:1124 PAJARO ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2929
Mailing Address - Country:US
Mailing Address - Phone:831-757-3021
Mailing Address - Fax:831-757-5833
Practice Address - Street 1:1124 PAJARO ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2929
Practice Address - Country:US
Practice Address - Phone:831-757-3021
Practice Address - Fax:831-757-5833
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA595751223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery