MEDICARE: ALAN KELMAN, DDS, PA

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	DN17054	FL

General Provider Information

NPI Number	:	1174818595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN KELMAN, DDS, PA

Provider Business Mailing Address
First Line	:	5909 SOUTH CONGRESS AVENUE
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462
Country	:	US
Telephone Number	:	561-967-6453
Fax Number	:	561-431-5866

Provider Business Practice Location Address
First Line	:	5909 SOUTH CONGRESS AVENUE
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462
Country	:	US
Telephone Number	:	561-967-6453
Fax Number	:	561-431-5866

Authorized Official
Title or Position	:	SOLE OWNER OF ALAN KELMAN, DDS, PA
Name	:	ALAN KELMAN
Credential	:	DDS
Telephone Number	:	561-967-6453

Provider Enumeration Date	:	06/14/2011
Last Update Date	:	06/14/2011

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