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Organization
JAMES CANNON ALLEN DDS PC
Active
Organization
JAMES CANNON ALLEN DDS PC
Active
Other names
Rockhouse Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES CANNON ALLEN DDS (DENTIST)
(208) 356-5600
Entity
Organization
Contact information
Practice address
106 E 1ST NORTH, REXBURG, ID 83440
(208) 356-5600
(208) 419-0202
Mailing address
106 E 1ST NORTH, REXBURG, ID 83440
(208) 356-5600
(208) 419-0202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3634
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9201769
—
ID
Enumeration date
10/05/2012
Last updated
10/05/2012
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