Provider Demographics
NPI:1306055843
Name:ALLEN, WILLIAM HAROLD III (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HAROLD
Last Name:ALLEN
Suffix:III
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 1:3360 TREMONT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2111
Mailing Address - Country:US
Mailing Address - Phone:614-451-7377
Mailing Address - Fax:614-538-2490
Practice Address - Street 1:3360 TREMONT RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2111
Practice Address - Country:US
Practice Address - Phone:614-451-7377
Practice Address - Fax:614-538-2490
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13830122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist