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Individual

ANA ALTONAGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
15215 S 48TH ST STE 158, PHOENIX, AZ 85044-9139
(480) 598-3006
Mailing address
16039 S 9TH PL, PHOENIX, AZ 85048-1941
(480) 460-2474

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4496
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200346842
TAX ID
AZ
Enumeration date
09/03/2015
Last updated
09/03/2015
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