Provider Demographics
NPI:1003062985
Name:MAN, ALISTER YI-HENG (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALISTER
Middle Name:YI-HENG
Last Name:MAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 SHADY TIMBER ST APT 2094
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8923
Mailing Address - Country:US
Mailing Address - Phone:702-735-0833
Mailing Address - Fax:
Practice Address - Street 1:7180 CASCADE VALLEY CT STE 240
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0481
Practice Address - Country:US
Practice Address - Phone:702-735-0833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA571751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice