Individual
DR. BRANDICE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2090 DUNWOODY CLUB DR, SUITE 105, SANDY SPRINGS, GA 30350-5434
(314) 276-2984
Mailing address
PO BOX 93542, ATLANTA, GA 30377-0542
(314) 276-2984
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9551
TN
1223P0221X
Pediatric Dentistry
Primary
DN 014898
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN014898
GEORGIA DENTAL LICENSE
GA
Enumeration date
08/14/2012
Last updated
11/18/2014
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