Provider Demographics
NPI:1275040347
Name:DOUGLAS J. ALTERMAN, D.M.D., P.A.
Entity Type:Organization
Organization Name:DOUGLAS J. ALTERMAN, D.M.D., P.A.
Other - Org Name:HARLESTON VILLAGE DENTAL EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-577-5210
Mailing Address - Street 1:86 RUTLEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1725
Mailing Address - Country:US
Mailing Address - Phone:843-577-5210
Mailing Address - Fax:843-722-8107
Practice Address - Street 1:86 RUTLEDGE AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1725
Practice Address - Country:US
Practice Address - Phone:843-577-5210
Practice Address - Fax:843-722-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty