Provider Demographics
NPI:1902896665
Name:ALTMAN, ALAN R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 HARMATI LN
Mailing Address - Street 2:
Mailing Address - City:BEARSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12409-5129
Mailing Address - Country:US
Mailing Address - Phone:845-679-2832
Mailing Address - Fax:
Practice Address - Street 1:268 TINKER ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1129
Practice Address - Country:US
Practice Address - Phone:845-670-6083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0272401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice