Provider Demographics
NPI:1891723904
Name:COLEMAN, ALLYN J (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ALLYN
Middle Name:J
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1354 S 117TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-2127
Mailing Address - Country:US
Mailing Address - Phone:414-258-0281
Mailing Address - Fax:
Practice Address - Street 1:ALEXANDRIA VA HEALTH CARE SYSTEM
Practice Address - Street 2:2495 SHREVEPORT HIGHWAY
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4044
Practice Address - Country:US
Practice Address - Phone:318-473-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0461241223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics