Individual
DR. ALLISON MARGARET MCLANE DEZARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
712 E MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1643
(502) 568-6972
(502) 996-8309
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4700
(502) 772-8189
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8163
KY
1223G0001X
General Practice Dentistry
Primary
8163
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60002870
—
KY
Enumeration date
02/15/2006
Last updated
05/28/2024
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