Provider Demographics
NPI:1689751067
Name:ALLMAN, CASEY CRAIG (DMD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:CRAIG
Last Name:ALLMAN
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 1:5740 NIGHT WHISPER RD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-1575
Mailing Address - Country:US
Mailing Address - Phone:505-792-1585
Mailing Address - Fax:505-792-1587
Practice Address - Street 1:5740 NIGHT WHISPER RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-1575
Practice Address - Country:US
Practice Address - Phone:505-792-1585
Practice Address - Fax:505-792-1587
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD2838122300000X
NV5051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist