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Individual

DANIEL JOSEPH ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12013307A
IN
390200000X
Student in an Organized Health Care Education/Training Program
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300036174
IN
Enumeration date
04/04/2019
Last updated
02/12/2023
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