Organization
ALLEN PORTLAND DENTISTRY ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES M. ALLEN JR. DDS, MS (OWNER)
(361) 854-7999
Entity
Organization
Contact information
Practice address
101 COX DR., PORTLAND, TX 78374
(361) 643-0416
(361) 643-3972
Mailing address
101 COX DR., PORTLAND, TX 78374
(361) 643-0416
(361) 643-3972
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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