Individual
DR. SAMUEL EDWARD ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7505 TOWER RD, SOUTH LYON, MI 48178-7051
(248) 437-9328
Mailing address
7505 TOWER RD, PO BOX 456, SOUTH LYON, MI 48178-0456
(248) 437-9328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901010995
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901010995
MICHIGAN DENTAL LICENSE
MI
Enumeration date
11/07/2006
Last updated
07/08/2007
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