Organization
ALTA DENTAL LLC
Active
Other names
ALTA DENTAL LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALTAY KHANMAMEDOV DDS (OWNER/PROVIDER)
(917) 881-5977
Entity
Organization
Contact information
Practice address
901 TEANECK RD FL 2N, TEANECK, NJ 07666-4511
(201) 837-2727
Mailing address
901 TEANECK RD FL 2N, TEANECK, NJ 07666-4511
(201) 837-2727
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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