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General NPI Number Information
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NPI Number | 1336299049
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Entity Type | Organization
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Legal Business Name | C MICHAEL ALTMAN DDS PC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1306 SOUTH BLUE BELL ROAD
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City | BRENHAM
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State | TX
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Zip | 77833
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Country | US
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Telephone | 979-836-6767
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Fax | 979-836-5604
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Provider Business Mailing Address
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Address Line | 1306 SOUTH BLUE BELL ROAD
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City | BRENHAM
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State | TX
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Zip | 77833
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Country | US
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Telephone | 979-836-6767
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Fax | 979-836-5604
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES MICHAEL ALTMAN
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Credential |
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Telephone | 979-836-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16915
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17262
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License Number State | TX
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