MEDICARE: DR. ALAN F ALTMAN DDS, PC

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	122300000X	Dentist	5688	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5688	OTHER	WA	STATE DENTAL LICENSE

General Provider Information

NPI Number	:	1154328300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN F ALTMAN DDS, PC

Provider Business Mailing Address
First Line	:	2302 S UNION AVE
Second Line	:	SUITE A6
City	:	TACOMA
State	:	WA
Zip	:	98405-1300
Country	:	US
Telephone Number	:	253-752-4422
Fax Number	:	253-759-5724

Provider Business Practice Location Address
First Line	:	2302 S UNION AVE
Second Line	:	SUITE A6
City	:	TACOMA
State	:	WA
Zip	:	98405-1300
Country	:	US
Telephone Number	:	253-752-4422
Fax Number	:	253-759-5724

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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