Provider Demographics
NPI:1316916091
Name:MCLEOD, ALLEN KIRK (DDS)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:KIRK
Last Name:MCLEOD
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 1:7051 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4230
Mailing Address - Country:US
Mailing Address - Phone:540-366-1001
Mailing Address - Fax:540-366-5880
Practice Address - Street 1:7051 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-4230
Practice Address - Country:US
Practice Address - Phone:540-366-1001
Practice Address - Fax:540-366-5880
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA7201122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist