Provider Demographics
NPI:1730246000
Name:TERRENCE L. ALLEMANG, DDS INC.
Entity type:Organization
Organization Name:TERRENCE L. ALLEMANG, DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLEMANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-667-0776
Mailing Address - Street 1:1487 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-2803
Mailing Address - Country:US
Mailing Address - Phone:937-667-0776
Mailing Address - Fax:937-667-0854
Practice Address - Street 1:1487 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2803
Practice Address - Country:US
Practice Address - Phone:937-667-0776
Practice Address - Fax:937-667-0854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300161641223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000264404OtherABCBS PROVIDER #
OH2403296Medicaid
OHTE9338341Medicare ID - Type UnspecifiedGROUP #
OH000000264404OtherABCBS PROVIDER #