# ALTIERI DENTAL,PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578710398
- **Authorized official:** DR. KEVIN M ALTIERI DDS (PRESIDENT/ DENTIST)
- **Authorized official phone:** (817) 294-5513

## Contact information

- **Practice address:** 5521 BELLAIRE DR S, SUITE202, FORT WORTH, TX 76109-8838
- **Practice address phone:** (817) 294-5513
- **Mailing address:** 5521 BELLAIRE DR S, SUITE202, FORT WORTH, TX 76109-8838
- **Mailing address phone:** (817) 294-5513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 16950 | TX | Yes |

## Other

- **Enumeration date:** 08/22/2008
- **Last updated:** 11/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 091186903 | — | TX |
| 05 | — | 157688601 | — | TX |