Provider Demographics
NPI:1225364680
Name:ALLMARAS, OBADIAH MICHAEL (DDS)
Entity type:Individual
Prefix:
First Name:OBADIAH
Middle Name:MICHAEL
Last Name:ALLMARAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N COLLEGE PARK DR
Mailing Address - Street 2:APT N36
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-8883
Mailing Address - Country:US
Mailing Address - Phone:918-628-2528
Mailing Address - Fax:
Practice Address - Street 1:3551 PECK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3547
Practice Address - Country:US
Practice Address - Phone:918-628-2528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6435-15122300000X
CA64101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist