MEDICARE: TROY A ALTON DDS

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)	4881	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11548	OTHER	WI	DEAN HEALTH PROVIDER #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073555850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY A ALTON DDS

Provider Business Mailing Address
First Line	:	7795 SUMMERFIELD DR
Second Line	:
City	:	VERONA
State	:	WI
Zip	:	53593-8663
Country	:	US
Telephone Number	:	608-833-8504
Fax Number	:

Provider Business Practice Location Address
First Line	:	5801 RESEARCH PARK BLVD
Second Line	:	STE 110
City	:	MADISON
State	:	WI
Zip	:	53719-6002
Country	:	US
Telephone Number	:	608-274-0770
Fax Number	:	608-274-9224

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/09/2007

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