Individual provider · NPI-1

Bradford Moncrief Allen, D.D.S.

Dentist, General Practice · Peoria, AZ

NPI number1376665323
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1376665323
Entity type
Individual (NPI-1)
Name
Bradford Moncrief Allen
Credential
D.D.S.
Sex
Male
Sole proprietor
No
Enumeration date
Apr 3, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice3224AZYes

Practice location

13470 N 83rd Ave Ste 100
Peoria, AZ 85381-4148

Phone 623-412-9600 · Fax 623-412-9700

Mailing address

13470 N 83rd Ave Ste 100
Peoria, AZ 85381-4148

Phone 623-412-9600 · Fax 623-412-9700

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