Individual
DR. MICHAEL JAMES ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
36 BRADFORD STREET, BRISTOL, RI 02809
(401) 253-9636
(401) 253-0150
Mailing address
36 BRADFORD STREET, BRISTOL, RI 02809
(401) 253-9636
(401) 253-0150
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DENO1967
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206388
BLUE CROSS
MA
01
—
80507
BLUE CROSS
RI
Enumeration date
08/29/2007
Last updated
08/29/2007
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