# ALTAVAS DENTAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Qualident USA LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518295724
- **Authorized official:** MYRNA RAMOS ALTAVAS D.D.S. (PRESIDENT)
- **Authorized official phone:** (661) 343-5018

## Contact information

- **Practice address:** 4100 EMPIRE DRIVE, SUITE 110, BAKERSFIELD, CA 93309
- **Practice address phone:** (661) 246-4322
- **Mailing address:** 10304 SKILES DRIVE, BAKERSFIELD, CA 93311
- **Mailing address phone:** (661) 343-5018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 57548 | CA | Yes |

## Other

- **Enumeration date:** 11/28/2009
- **Last updated:** 06/14/2011