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Provider Information for 1255344453

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. KATHIE SUE ALLEN DDS

Gender: FEMALE

Individual NPI: 1255344453

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1255344453
Enumeration Date 2006-08-15
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 836 SUNSET LAKE BLVD SUITE #204 LAKESIDE MEDICAL CENTER
VENICE, FL 34292-7556
United States

Phone: 941-492-3211 | Fax: 941-492-3212
View Map External Link
Primary Practice Address 836 SUNSET LAKE BLVD SUITE #204
VENICE, FL 34292-7556
United States

Phone: 941-492-3211 | Fax: 941-492-3212
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice FL DN0013632