# JEREMY W. ALLEN DMD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508162629
- **Authorized official:** DR. JEREMY W ALLEN DMD (DENTIST)
- **Authorized official phone:** (606) 231-0594

## Contact information

- **Practice address:** 908 W 5TH ST, SUITE 114, LONDON, KY 40741-2417
- **Practice address phone:** (606) 231-0594
- **Mailing address:** 908 W 5TH ST, SUITE 114, LONDON, KY 40741-2417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 8365 | KY | — |
| 1223G0001X | General Practice Dentistry | 8365 | KY | Yes |

## Other

- **Enumeration date:** 02/07/2011
- **Last updated:** 03/22/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 60004306 | — | KY |