Provider Demographics
NPI:1821168675
Name:MAULDEN, ALLISON PATRICIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:PATRICIA
Last Name:MAULDEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E 10TH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5771
Mailing Address - Country:US
Mailing Address - Phone:256-741-7340
Mailing Address - Fax:256-741-7373
Practice Address - Street 1:5412 MONTGOMERY HWY STE 8
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-1657
Practice Address - Country:US
Practice Address - Phone:334-983-1730
Practice Address - Fax:334-983-1725
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0129811223G0001X
AL55631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1679318OtherUNITED CONCORDIA
AL181493Medicaid
AL104148Medicaid