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NPI Code Detail

MEDICARE: ABSOLUTE DENTAL NELLIS, LLC

MEDICARE: ABSOLUTE DENTAL NELLIS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

General Provider Information

NPI Number : 1063607315
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABSOLUTE DENTAL NELLIS, LLC
Provider Business Mailing Address
First Line : 169 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5320
Country : US
Telephone Number : 702-435-5015
Fax Number : 702-366-1483
Provider Business Practice Location Address
First Line : 169 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5320
Country : US
Telephone Number : 702-435-5015
Fax Number : 702-366-1483
Authorized Official
Title or Position : OWNER
Name : DR. MICHAEL A ALTERMAN
Credential :
Telephone Number : 702-435-5015
Provider Enumeration Date : 09/10/2007
Last Update Date : 09/10/2007

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Directions to “ABSOLUTE DENTAL NELLIS, LLC ” Practice Location

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