Provider Demographics
NPI:1619180460
Name:TROUT, ALLISON C (DDS)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:C
Last Name:TROUT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6560 LONETREE BLVD
Mailing Address - Street 2:STE #102
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765
Mailing Address - Country:US
Mailing Address - Phone:916-435-9799
Mailing Address - Fax:916-435-1718
Practice Address - Street 1:6560 LONETREE BLVD
Practice Address - Street 2:STE #102
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765
Practice Address - Country:US
Practice Address - Phone:916-435-9799
Practice Address - Fax:916-435-1718
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45334122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist