# JAMES CANNON ALLEN DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rockhouse Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033461660
- **Authorized official:** DR. JAMES CANNON ALLEN DDS (DENTIST)
- **Authorized official phone:** (208) 356-5600

## Contact information

- **Practice address:** 106 E 1ST NORTH, REXBURG, ID 83440
- **Practice address phone:** (208) 356-5600
- **Practice address fax:** (208) 419-0202
- **Mailing address:** 106 E 1ST NORTH, REXBURG, ID 83440
- **Mailing address phone:** (208) 356-5600
- **Mailing address fax:** (208) 419-0202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D-3634 | ID | Yes |

## Other

- **Enumeration date:** 10/05/2012
- **Last updated:** 10/05/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9201769 | — | ID |