Provider Demographics
NPI:1851466452
Name:WARD, ALLEN MCCREARY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:MCCREARY
Last Name:WARD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 E THREE NOTCH ST
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-3167
Mailing Address - Country:US
Mailing Address - Phone:334-222-6477
Mailing Address - Fax:334-427-4217
Practice Address - Street 1:406 E THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-3167
Practice Address - Country:US
Practice Address - Phone:334-222-6477
Practice Address - Fax:334-427-4217
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4472122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist