MEDICARE: DR. ALAN THOMAS MCCAFFREY DMD

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
1	1223G0001X	General Practice Dentistry	5113	NV

General Provider Information

NPI Number	:	1518063866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN THOMAS MCCAFFREY DMD

Provider Business Mailing Address
First Line	:	900 S PAVILION CENTER DR STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4583
Country	:	US
Telephone Number	:	702-243-8788
Fax Number	:	702-243-5785

Provider Business Practice Location Address
First Line	:	900 S PAVILION CENTER DR STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4583
Country	:	US
Telephone Number	:	702-243-8788
Fax Number	:	702-243-5785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	11/17/2022

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