Provider Demographics
NPI:1902293228
Name:ALLEN, LEE BRANDON (DDS)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:BRANDON
Last Name:ALLEN
Suffix:
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 1:8508 BABBLE LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3800
Mailing Address - Country:US
Mailing Address - Phone:919-880-9483
Mailing Address - Fax:
Practice Address - Street 1:5400 BARBER MILL RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-7260
Practice Address - Country:US
Practice Address - Phone:919-553-2238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9711122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist