MEDICARE: DR. ALAN R ALTMAN 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	1223G0001X	General Practice Dentistry	027240	NY

General Provider Information

NPI Number	:	1902896665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN R ALTMAN DDS

Provider Business Mailing Address
First Line	:	96 HARMATI LN
Second Line	:
City	:	BEARSVILLE
State	:	NY
Zip	:	12409-5129
Country	:	US
Telephone Number	:	845-679-2832
Fax Number	:

Provider Business Practice Location Address
First Line	:	268 TINKER ST
Second Line	:
City	:	WOODSTOCK
State	:	NY
Zip	:	12498-1129
Country	:	US
Telephone Number	:	845-670-6083
Fax Number	:

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	11/01/2007

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