Gary Lee Allred, DDS

Individual provider Active NPI General Practice Dentistry · Mount Vernon, MO

NPI 1992807127 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992807127
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2006012626 (MO)
Practice address
1050 W Hayward Dr
Mount Vernon, MO 65712-6329
Phone
(417) 466-7184
Fax
(417) 466-4081
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2006012626MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
J. Warren Hildreth, Jr DDS PC of Missouri General Practice Past Accepting new patients
Mid - America Hearing Center, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2006012626 MO Yes

Addresses

Primary practice location

1050 W Hayward Dr
Mount Vernon, MO 65712-6329

Mailing address

1050 W Hayward Dr
Mount Vernon, MO 65712-6329
Phone (417) 466-7184

Other providers in Mount Vernon, MO

All providers in Mount Vernon, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.