Provider Demographics
NPI:1760865257
Name:JUNG, ALLISON M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:M
Last Name:JUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 WILMINGTON DR
Mailing Address - Street 2:#202
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-6403
Mailing Address - Country:US
Mailing Address - Phone:970-484-4850
Mailing Address - Fax:970-484-2757
Practice Address - Street 1:1927 WILMINGTON DR
Practice Address - Street 2:#202
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-6403
Practice Address - Country:US
Practice Address - Phone:970-484-4850
Practice Address - Fax:970-484-2757
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00202555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist