Provider Demographics
NPI:1063570869
Name:ALLISON, CHARYL F (CDA)
Entity type:Individual
Prefix:MRS
First Name:CHARYL
Middle Name:F
Last Name:ALLISON
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W TRYON ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2438
Mailing Address - Country:US
Mailing Address - Phone:919-245-2435
Mailing Address - Fax:919-644-3368
Practice Address - Street 1:200 N GREENSBORO ST
Practice Address - Street 2:CARR MILL MALL SUITE D15
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1833
Practice Address - Country:US
Practice Address - Phone:919-968-2040
Practice Address - Fax:919-968-2021
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404475Medicaid
NC07146OtherBCBS NC