Provider Demographics
NPI:1013925502
Name:ALTSCHULER, GARY IAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:IAN
Last Name:ALTSCHULER
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 1:2251 NW 41ST ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7498
Mailing Address - Country:US
Mailing Address - Phone:352-371-4141
Mailing Address - Fax:352-371-4169
Practice Address - Street 1:2251 NW 41ST ST
Practice Address - Street 2:SUITE F
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7498
Practice Address - Country:US
Practice Address - Phone:352-371-4141
Practice Address - Fax:352-371-4169
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN122571223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics