Provider Demographics
NPI:1750477295
Name:CHANTRY, ALLEN EARL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:EARL
Last Name:CHANTRY
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 1:3300 CAMERON PARK DR STE 3000
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-7998
Mailing Address - Country:US
Mailing Address - Phone:530-672-2121
Mailing Address - Fax:530-672-0300
Practice Address - Street 1:3300 CAMERON PARK DR STE 3000
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7998
Practice Address - Country:US
Practice Address - Phone:530-672-2121
Practice Address - Fax:530-672-0300
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA437671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice