Provider Demographics
NPI:1639230972
Name:ALLEN, ROB (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROB
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 1:3023 THOUSAND OAKS DR
Mailing Address - Street 2:STE 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3556
Mailing Address - Country:US
Mailing Address - Phone:210-497-6700
Mailing Address - Fax:210-497-6706
Practice Address - Street 1:3023 THOUSAND OAKS DR
Practice Address - Street 2:STE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3556
Practice Address - Country:US
Practice Address - Phone:210-497-6700
Practice Address - Fax:210-497-6706
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26468122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist