Provider Demographics
NPI:1730306952
Name:ALTEIR, NIZAR (DDS)
Entity Type:Individual
Prefix:
First Name:NIZAR
Middle Name:
Last Name:ALTEIR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 W BALL RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5272
Mailing Address - Country:US
Mailing Address - Phone:714-826-9000
Mailing Address - Fax:714-827-8000
Practice Address - Street 1:2424 W BALL RD
Practice Address - Street 2:SUITE L
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-5272
Practice Address - Country:US
Practice Address - Phone:714-826-9000
Practice Address - Fax:714-827-8000
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA413391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD41339OtherDENTI-CAL TREATING DDS ID