Individual
JOHN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
301 W MAIN ST, FARWELL, MI 48622-8753
(989) 588-4121
(989) 588-3191
Mailing address
PO BOX 309, FARWELL, MI 48622-0309
(989) 588-4121
(989) 588-3191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10385
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D800279
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/13/2006
Last updated
07/08/2007
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