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Organization
ALTIERI DENTAL,PC
Active
Organization
ALTIERI DENTAL,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN M ALTIERI DDS (PRESIDENT/ DENTIST)
(817) 294-5513
Entity
Organization
Contact information
Practice address
5521 BELLAIRE DR S, SUITE202, FORT WORTH, TX 76109-8838
(817) 294-5513
Mailing address
5521 BELLAIRE DR S, SUITE202, FORT WORTH, TX 76109-8838
(817) 294-5513
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16950
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091186903
—
TX
05
—
157688601
—
TX
Enumeration date
08/22/2008
Last updated
11/18/2015
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