Individual
MARK ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
151 NORTH MAIN ST, HARDWICK, VT 05843
(802) 472-2260
Mailing address
PO BOX 388, 165 SHERMAN DRIVE, ST JOHNSBURY, VT 05819-0388
(802) 748-9405
(802) 748-4540
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
160002025
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006037
—
VT
Enumeration date
04/21/2006
Last updated
02/13/2012
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