Provider Demographics
NPI:1205444288
Name:ALTRUISTIC DENTAL SMILES
Entity type:Organization
Organization Name:ALTRUISTIC DENTAL SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN-CATHERINE
Authorized Official - Middle Name:PINEDA
Authorized Official - Last Name:BAUTISTA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:510-640-6268
Mailing Address - Street 1:163 CYPRESS LOOP
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-2541
Mailing Address - Country:US
Mailing Address - Phone:510-640-6268
Mailing Address - Fax:510-397-0017
Practice Address - Street 1:163 CYPRESS LOOP
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-2541
Practice Address - Country:US
Practice Address - Phone:510-640-6268
Practice Address - Fax:510-397-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental