Provider Demographics
NPI:1821283847
Name:ALLEN, HERMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:
Last Name:ALLEN
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 1:2323 NW 19TH STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-3400
Mailing Address - Country:US
Mailing Address - Phone:954-484-8780
Mailing Address - Fax:954-484-8781
Practice Address - Street 1:2323 NW 19TH STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-3400
Practice Address - Country:US
Practice Address - Phone:954-484-8780
Practice Address - Fax:954-484-8781
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN4505122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist