Individual
HENRY TODD ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
22690 WASHINGTON STREET, LEONARDTOWN, MD 20650
(301) 997-1200
(301) 997-1240
Mailing address
PO BOX 1510, LEONARDTOWN, MD 20650
(301) 997-1200
(301) 997-1240
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401008109
VA
1223G0001X
General Practice Dentistry
Primary
10575
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
602994
UNITED CONCORDIA CO INC
—
01
—
DG20T0
BLUE SHIELD OF MD
—
Enumeration date
07/08/2008
Last updated
07/08/2008
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