Individual
KATRINA ALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
13395 N MARANA MAIN ST, MARANA, AZ 85653-7008
(520) 616-6200
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009503
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D009503
LICENSE
AZ
Enumeration date
06/14/2016
Last updated
06/14/2016
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