Provider Demographics
NPI:1821142050
Name:PURCELL, ALLISON (DDS)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:PURCELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:PURCELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1612 HUGUENOT ROAD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-794-9789
Mailing Address - Fax:804-794-9762
Practice Address - Street 1:6353 MECHANICSVILLE TPKE
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111
Practice Address - Country:US
Practice Address - Phone:804-730-3400
Practice Address - Fax:804-559-4995
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014103751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics