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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