Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 4881 | WI |
NPI | 1073555850 |
---|---|
Provider Name | Troy A Alton |
First Address | Verona, WI 53593-8663 |
Second Address | Madison, WI 53719-6002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11548 | DEAN HEALTH PROVIDER # (01) | WI |
33740700 | (05) | WI |
U66107 | (02) | WI |