MEDICARE: DR. ALAN KLEIMAN 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DI10767	NJ
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DTP730	FL

General Provider Information

NPI Number	:	1043215205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN KLEIMAN D.M.D.

Provider Business Mailing Address
First Line	:	7881 AMETHYST LAKE PT
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6976
Country	:	US
Telephone Number	:	856-296-2149
Fax Number	:	561-594-1468

Provider Business Practice Location Address
First Line	:	7881 AMETHYST LAKE PT
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6976
Country	:	US
Telephone Number	:	856-296-2149
Fax Number	:	561-594-1468

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	04/16/2023

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