Provider Demographics
NPI:1730557786
Name:MCCLARY, ALLENE I (RDH)
Entity type:Individual
Prefix:
First Name:ALLENE
Middle Name:I
Last Name:MCCLARY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 SCARLET OAK LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-2485
Mailing Address - Country:US
Mailing Address - Phone:410-493-1965
Mailing Address - Fax:
Practice Address - Street 1:4505 SCARLET OAK LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-2485
Practice Address - Country:US
Practice Address - Phone:410-493-1965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6961124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist