Individual
MR. ROBERT ELLIS ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
248 EAST 5TH STREET, RUSSELLVILLE, KY 42276
(270) 726-2274
(270) 726-8825
Mailing address
PO BOX 1210, RUSSELLVILLE, KY 42276
(270) 726-2274
(270) 726-8825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7570
KY
1223G0001X
General Practice Dentistry
7570
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60000494
—
KY
Enumeration date
02/13/2007
Last updated
05/06/2008
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