Healthcare Provider Details

I. General information

NPI: 1588754949
Provider Name (Legal Business Name): FRANK ALTIER JR. D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5329 S TATUM LN
GILBERT AZ
85298-0356
US

IV. Provider business mailing address

5329 S TATUM LN
GILBERT AZ
85298-0356
US

V. Phone/Fax

Practice location:
  • Phone: 724-217-2707
  • Fax:
Mailing address:
  • Phone: 724-217-2707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD07553
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS030159L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: