Provider Demographics
NPI:1487752101
Name:HOUSE, ALLISON BORDEN (DMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:BORDEN
Last Name:HOUSE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5033 N 44TH ST
Mailing Address - Street 2:SUITE C-9
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-1622
Mailing Address - Country:US
Mailing Address - Phone:602-957-4576
Mailing Address - Fax:602-957-4579
Practice Address - Street 1:5033 N 44TH ST
Practice Address - Street 2:SUITE C-9
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-1622
Practice Address - Country:US
Practice Address - Phone:602-957-4576
Practice Address - Fax:602-957-4579
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD52681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice