Provider Demographics
NPI:1720096779
Name:EWING, ALLEN N (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:N
Last Name:EWING
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 1:14 N MAIN ST
Mailing Address - Street 2:RM #224
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201
Mailing Address - Country:US
Mailing Address - Phone:717-264-7012
Mailing Address - Fax:717-264-7012
Practice Address - Street 1:14 N MAIN ST
Practice Address - Street 2:RM #224
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-264-7012
Practice Address - Fax:717-264-7012
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA DS017805L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist