Individual
JASON ALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
6759 1ST AVE S, ST PETERSBURG, FL 33707-1307
(305) 321-1752
Mailing address
430 3RD AVE S APT 205, ST PETERSBURG, FL 33701-4181
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D11722
OR
122300000X
Dentist
DN22099
FL
1223G0001X
General Practice Dentistry
Primary
D11722
OR
Other
Enumeration date
07/14/2016
Last updated
01/12/2023
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