Provider Demographics
NPI:1710080643
Name:ALLEN, FRANCIS W (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:W
Last Name:ALLEN
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 1:5366 WHIPPLEWOOD AVE SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-1802
Mailing Address - Country:US
Mailing Address - Phone:503-361-0109
Mailing Address - Fax:503-428-6425
Practice Address - Street 1:5135 SKYLINE RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-9427
Practice Address - Country:US
Practice Address - Phone:503-588-6560
Practice Address - Fax:503-371-9822
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD51431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice