Provider Demographics
NPI:1952635088
Name:ALLEN, NOLAN WHEELER (DDS)
Entity Type:Individual
Prefix:DR
First Name:NOLAN
Middle Name:WHEELER
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 1:2226 DRUID RD E
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-4935
Mailing Address - Country:US
Mailing Address - Phone:727-797-8800
Mailing Address - Fax:727-791-3820
Practice Address - Street 1:2226 DRUID RD E
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-4935
Practice Address - Country:US
Practice Address - Phone:727-797-8800
Practice Address - Fax:727-791-3820
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL56181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice