Individual
DR. MARY DISA RAULFS ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4051 POSTAL DR, ROANOKE, VA 24018-6439
(540) 774-0061
Mailing address
4051 POSTAL DR, ROANOKE, VA 24018-6439
(540) 774-0061
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414341
VA
1223G0001X
General Practice Dentistry
R544
MN
Other
Enumeration date
04/10/2013
Last updated
05/14/2014
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