Provider Demographics
NPI:1326191040
Name:ABSOLUTE DENTAL SOUTH RENO, LLC
Entity Type:Organization
Organization Name:ABSOLUTE DENTAL SOUTH RENO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-787-8900
Mailing Address - Street 1:6490 S MCCARRAN BLVD
Mailing Address - Street 2:SUITE 17
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6102
Mailing Address - Country:US
Mailing Address - Phone:775-787-8900
Mailing Address - Fax:
Practice Address - Street 1:6490 S MCCARRAN BLVD
Practice Address - Street 2:SUITE 17
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6102
Practice Address - Country:US
Practice Address - Phone:775-787-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty