Individual
JELLE ALTENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
100 WATCHTOWER DR, PATTERSON, NY 12563-2232
(845) 306-1000
Mailing address
100 WATCHTOWER DR, PATTERSON, NY 12563-2232
(845) 306-1000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
042454-1
NY
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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