Provider Demographics
NPI:1740238880
Name:ALLEN, CHARLES MCKEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MCKEAN
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6200 SARATOGA BLVD
Mailing Address - Street 2:BLDG 2 102
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3421
Mailing Address - Country:US
Mailing Address - Phone:361-992-8900
Mailing Address - Fax:361-992-0880
Practice Address - Street 1:6200 SARATOGA BLVD
Practice Address - Street 2:BLDG 2 102
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3421
Practice Address - Country:US
Practice Address - Phone:361-992-8900
Practice Address - Fax:361-992-0880
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX97531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice