Individual
ALLEN CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3607 OAK LAWN AVE STE 250, DALLAS, TX 75219-4788
(214) 699-4976
(214) 712-4940
Mailing address
3607 OAK LAWN AVE STE 250, DALLAS, TX 75219-4788
(214) 699-4976
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
15418
MD
122300000X
Dentist
30681
TX
122300000X
Dentist
DEN1001373
DC
1223G0001X
General Practice Dentistry
30681
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30681
TX
Other
Enumeration date
06/06/2013
Last updated
04/30/2024
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