Provider Demographics
NPI:1568444016
Name:ALLISON, ERROL JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERROL
Middle Name:JAMES
Last Name:ALLISON
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 1:1 PLAZA SOUTH ST
Mailing Address - Street 2:SUITE 149
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-4750
Mailing Address - Country:US
Mailing Address - Phone:918-456-3311
Mailing Address - Fax:918-456-1254
Practice Address - Street 1:3070 S MUSKOGEE AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-5402
Practice Address - Country:US
Practice Address - Phone:918-456-3311
Practice Address - Fax:918-456-1254
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK48631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice