Allen, Mark Derrick
Allen, Mark Derrick is an sole proprietor health care provider with primary practice located at 2861 Ridge Rd , Rockwall TX 75032. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Allen, Mark Derrick can be contacted via phone (972) 772-2500.Contact Information
Primary practice address
2861 Ridge Rd
Rockwall TX 75032
Phone: (972) 772-2500
Fax: (972) 278-1320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 16321 | Texas |
Profile Details
| NPI number | 1528357803 |
|---|---|
| LBN Legal business name | Allen, Mark Derrick |
| Credentials | DDS MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 7th, 2011 |
| Last updated | Jan 13th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528357803 | NPPES |
| Texas | MEDICAID | 1927816 |
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