Provider Demographics
NPI:1801000708
Name:ALTIG, WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:ALTIG
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 1:2530 CAMEO DR
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-9000
Mailing Address - Country:US
Mailing Address - Phone:530-676-9999
Mailing Address - Fax:
Practice Address - Street 1:2530 CAMEO DR STE 2
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-9000
Practice Address - Country:US
Practice Address - Phone:530-676-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA448141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice