Provider Demographics
NPI:1811070618
Name:PARLER, ALLEN L (DDS)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:L
Last Name:PARLER
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 1:330 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANNINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26582-1102
Mailing Address - Country:US
Mailing Address - Phone:304-986-2610
Mailing Address - Fax:304-986-2919
Practice Address - Street 1:330 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MANNINGTON
Practice Address - State:WV
Practice Address - Zip Code:26582-1102
Practice Address - Country:US
Practice Address - Phone:304-986-2610
Practice Address - Fax:304-986-2919
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0137085000Medicaid