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Organization

JEREMY W. ALLEN DMD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEREMY W ALLEN DMD (DENTIST)
(606) 231-0594
Entity
Organization

Contact information

Practice address
908 W 5TH ST, SUITE 114, LONDON, KY 40741-2417
(606) 231-0594
Mailing address
908 W 5TH ST, SUITE 114, LONDON, KY 40741-2417

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8365
KY
1223G0001X
General Practice Dentistry
Primary
8365
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60004306
KY
Enumeration date
02/07/2011
Last updated
03/22/2011
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