Provider Demographics
NPI:1568626265
Name:SEGELMAN, ALLYN E (DMD, SM, SM)
Entity type:Individual
Prefix:DR
First Name:ALLYN
Middle Name:E
Last Name:SEGELMAN
Suffix:
Gender:M
Credentials:DMD, SM, SM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20423 STATE RD 7
Mailing Address - Street 2:SUITE F18
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6797
Mailing Address - Country:US
Mailing Address - Phone:561-886-0288
Mailing Address - Fax:561-886-0291
Practice Address - Street 1:20423 STATE ROAD 7
Practice Address - Street 2:SUITE F18
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6797
Practice Address - Country:US
Practice Address - Phone:561-886-0288
Practice Address - Fax:561-886-0291
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 183551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAT57177Medicare UPIN