Provider Demographics
NPI:1962547943
Name:ALLEN, WILLIAM G (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:150 S HOUGHTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-6704
Mailing Address - Country:US
Mailing Address - Phone:520-721-2000
Mailing Address - Fax:520-721-2014
Practice Address - Street 1:150 S HOUGHTON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-6704
Practice Address - Country:US
Practice Address - Phone:520-721-2000
Practice Address - Fax:520-721-2014
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2849122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist