Individual
JEFFREY TODD ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
359 E WINSLOW RD, BLOOMINGTON, IN 47401-7327
(812) 332-1028
(812) 332-1097
Mailing address
359 E WINSLOW RD, BLOOMINGTON, IN 47401-7327
(812) 332-1028
(812) 332-1097
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009743
IN
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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