Provider Demographics
NPI:1073943981
Name:ALTATARI DDS, PLLC
Entity Type:Organization
Organization Name:ALTATARI DDS, PLLC
Other - Org Name:SMOKY HILL FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RABI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTATARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-596-7652
Mailing Address - Street 1:16629 E SMOKY HILL RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1764
Mailing Address - Country:US
Mailing Address - Phone:303-699-8788
Mailing Address - Fax:303-699-9011
Practice Address - Street 1:16629 E SMOKY HILL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1764
Practice Address - Country:US
Practice Address - Phone:303-699-8788
Practice Address - Fax:303-699-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9749261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental