Provider Demographics
NPI:1154328300
Name:ALTMAN, ALAN F (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:F
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 S UNION AVE
Mailing Address - Street 2:SUITE A6
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1300
Mailing Address - Country:US
Mailing Address - Phone:253-752-4422
Mailing Address - Fax:253-759-5724
Practice Address - Street 1:2302 S UNION AVE
Practice Address - Street 2:SUITE A6
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1300
Practice Address - Country:US
Practice Address - Phone:253-752-4422
Practice Address - Fax:253-759-5724
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5688OtherSTATE DENTAL LICENSE