Mclane Dezarn, Allison Margaret

Mclane Dezarn, Allison Margaret is an individual health care provider with primary practice located at 712 E Muhammad Ali Blvd , Louisville KY 40202-1643. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Mclane Dezarn, Allison Margaret can be contacted via phone (502) 568-6972.

Contact Information

Primary practice address
712 E Muhammad Ali Blvd Louisville KY 40202-1643
Phone: (502) 568-6972
Fax: (502) 996-8309
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 8163 Kentucky
Dental Providers / General Practice 1223G0001X 8163 Kentucky

Profile Details

NPI number 1548234685
LBN Legal business name Mclane Dezarn, Allison Margaret
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated May 28th, 2024 - about 7 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548234685 NPPES
Kentucky MEDICAID 60002870

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