Individual
DR. SAMUEL BROOKS ALLEN
Active
Individual
DR. SAMUEL BROOKS ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19030584
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19030584
LICENSE
IL
Enumeration date
05/26/2016
Last updated
05/26/2016
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