Provider Demographics
NPI:1609061209
Name:LEVINE, ALLEN MARTIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:MARTIN
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:692 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2538
Mailing Address - Country:US
Mailing Address - Phone:732-388-0314
Mailing Address - Fax:732-388-3452
Practice Address - Street 1:692 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2538
Practice Address - Country:US
Practice Address - Phone:732-388-0314
Practice Address - Fax:732-388-3452
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI009485001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice