Provider Demographics
NPI:1942399076
Name:ALTMAN, MEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEL
Middle Name:
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 1:2 CARRIAGE RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3118
Mailing Address - Country:US
Mailing Address - Phone:516-248-7077
Mailing Address - Fax:
Practice Address - Street 1:2 CARRIAGE RD
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-3118
Practice Address - Country:US
Practice Address - Phone:516-248-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice