Provider Demographics
NPI:1538708664
Name:CASSIE ALLISON, DDS, PLLC
Entity type:Organization
Organization Name:CASSIE ALLISON, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-281-8633
Mailing Address - Street 1:4201 BROWN TRL STE 104
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3941
Mailing Address - Country:US
Mailing Address - Phone:817-281-8633
Mailing Address - Fax:
Practice Address - Street 1:4201 BROWN TRL STE 104
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3941
Practice Address - Country:US
Practice Address - Phone:817-281-8633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental