MEDICARE: DR. ALISTER YI-HENG MAN D.M.D.

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	57175	CA

General Provider Information

NPI Number	:	1003062985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALISTER YI-HENG MAN D.M.D.

Provider Business Mailing Address
First Line	:	3501 SHADY TIMBER ST APT 2094
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8923
Country	:	US
Telephone Number	:	702-735-0833
Fax Number	:

Provider Business Practice Location Address
First Line	:	7180 CASCADE VALLEY CT STE 240
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0481
Country	:	US
Telephone Number	:	702-735-0833
Fax Number	:

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

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	08/12/2008

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