Provider Demographics
NPI:1043223951
Name:MALTMAN, ALLAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
Last Name:MALTMAN
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 1:624 NUTLEY PLACE
Mailing Address - Street 2:
Mailing Address - City:NORTH WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11581
Mailing Address - Country:US
Mailing Address - Phone:516-791-5514
Mailing Address - Fax:516-791-7358
Practice Address - Street 1:624 NUTLEY PLACE
Practice Address - Street 2:
Practice Address - City:NORTH WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11581
Practice Address - Country:US
Practice Address - Phone:516-791-5514
Practice Address - Fax:516-791-7358
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist