Provider Demographics
NPI:1710964762
Name:EHLERS, ALLEN R (DDS)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:R
Last Name:EHLERS
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 1:1585 HEARTWOOD DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-3991
Mailing Address - Country:US
Mailing Address - Phone:707-839-3284
Mailing Address - Fax:707-839-2910
Practice Address - Street 1:1585 HEARTWOOD DR
Practice Address - Street 2:SUITE B
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-3991
Practice Address - Country:US
Practice Address - Phone:707-839-3284
Practice Address - Fax:707-839-2910
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice