Provider Demographics
NPI:1871599910
Name:ALLEN, ZOEL GLEN II (DDS)
Entity type:Individual
Prefix:DR
First Name:ZOEL
Middle Name:GLEN
Last Name:ALLEN
Suffix:II
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 1:19 SE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PERRYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79070-3111
Mailing Address - Country:US
Mailing Address - Phone:806-435-5335
Mailing Address - Fax:806-435-2811
Practice Address - Street 1:19 SE 5TH AVE
Practice Address - Street 2:
Practice Address - City:PERRYTON
Practice Address - State:TX
Practice Address - Zip Code:79070-3111
Practice Address - Country:US
Practice Address - Phone:806-435-5335
Practice Address - Fax:806-435-2811
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX181091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice