Provider Demographics
NPI:1922357029
Name:ALLEN, DANIEL E (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
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 1:1099 N WALNUT AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5322
Mailing Address - Country:US
Mailing Address - Phone:830-625-2222
Mailing Address - Fax:830-715-0588
Practice Address - Street 1:1099 N WALNUT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5322
Practice Address - Country:US
Practice Address - Phone:830-625-2222
Practice Address - Fax:830-715-0588
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3754122300000X
TX28301122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM29274061Medicaid