Provider Demographics
NPI:1659110468
Name:ROEHR, ALLISON HELEN (DMD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:HELEN
Last Name:ROEHR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12322 JOSHUA CT
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-8031
Mailing Address - Country:US
Mailing Address - Phone:616-340-8923
Mailing Address - Fax:
Practice Address - Street 1:12322 JOSHUA CT
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-8031
Practice Address - Country:US
Practice Address - Phone:616-340-8923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI2901602259122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program