Individual
DR. MARK S ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1716 ASHLEY CIR, BOWLING GREEN, KY 42104-3366
(270) 842-0166
(270) 781-1055
Mailing address
1716 ASHLEY CIR, BOWLING GREEN, KY 42104-3366
(270) 842-0166
(270) 781-1055
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4550 341
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4550
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60045507
—
KY
05
—
64045503
—
KY
Enumeration date
12/20/2006
Last updated
05/14/2008
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