MEDICARE: ORAL SURGERY ASSOCIATES, INC

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	1223P0106X	Oral and Maxillofacial Pathology Dentistry

General Provider Information

NPI Number	:	1083701148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORAL SURGERY ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	3830 E FLAMINGO RD
Second Line	:	E-2
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6234
Country	:	US
Telephone Number	:	702-278-6411
Fax Number	:

Provider Business Practice Location Address
First Line	:	3830 E FLAMINGO RD
Second Line	:	E-2
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6234
Country	:	US
Telephone Number	:	702-278-6411
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL A ALTERMAN
Credential	:	DDS
Telephone Number	:	702-218-2713

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	08/22/2020

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