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Individual

BETTY H ALTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5760 MONTICELLO DRIVE, ST GABRIEL, LA 70776
(225) 642-9676
(225) 642-9676
Mailing address
5760 MONTICELLO DRIVE, ST GABRIEL, LA 70776
(985) 590-0443

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3642
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1836427
LA
Enumeration date
04/23/2007
Last updated
07/09/2007
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