Individual
ALFRED MATTHEW MACALTAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
JUNCTION OF HIGHWAY 371 NAVAJO ROUTE 9, CROWNPOINT, NM 87313-0358
(505) 786-5291
Mailing address
22 N SAN MATEO DR APT 107, SAN MATEO, CA 94401-2804
(917) 697-1269
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
025404
NY
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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