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Contact Information

GARY M ALTENBURG, DDS
450 W STATE ST STE 115
EAGLE, ID83616-7055
 Phone: 208-286-4200
 Fax: 208-286-4201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for GARY M ALTENBURG · (Male)

NPI Number 1356558852
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 05/16/2007
Last updated 07/07/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 46454
  • ID License # D-5078-EN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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