Provider Demographics
NPI:1356682140
Name:ALTMAN, CRAIG E (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:E
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 W CROSSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2697
Mailing Address - Country:US
Mailing Address - Phone:770-587-2727
Mailing Address - Fax:
Practice Address - Street 1:685 W CROSSVILLE RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2697
Practice Address - Country:US
Practice Address - Phone:770-587-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN008742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist