Individual
DR. MICHAEL THOMAS ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
419 N CHURCH ST, THOMASTON, GA 30286-3611
(706) 647-7111
Mailing address
419 N CHURCH ST, THOMASTON, GA 30286-3611
(706) 647-7111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10296
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00438743A
—
GA
Enumeration date
01/16/2007
Last updated
07/08/2007
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