Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GARY MICHAEL ALTENBURG, DDS
Active Sole ProprietorDR. GARY MICHAEL ALTENBURG, DDS is a Endodontics healthcare provider located in EAGLE, Idaho. NPI 1356558852 is currently active in the NPPES registry. Verify at CMS.
Endodontics · EAGLE, ID
Registration Details
- NPI Number
- 1356558852
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 16, 2007 (19.213675223994 yrs)
- Last Updated
- Jul 7, 2022
- Licenses
-
D-5078-EN (ID)46454 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
450 W STATE ST STE 115EAGLE, ID, 836167055Browse ID providers · Browse ZIP 83616
- Phone
- 2082864200
- Fax
- 2082864201
- Primary Specialty
-
Endodontics
1223E0200X
- Additional Specialty
- Endodontics
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.