Provider Demographics
NPI:1023622057
Name:MOPPS, ALLISON TAYLOR (DMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:TAYLOR
Last Name:MOPPS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1563 CAPRI LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1548
Mailing Address - Country:US
Mailing Address - Phone:765-993-1202
Mailing Address - Fax:
Practice Address - Street 1:1836 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-3822
Practice Address - Country:US
Practice Address - Phone:765-966-6802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013480A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist