Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DN12257 | FL |
NPI | 1013925502 |
---|---|
Provider Name | Dr. Gary Ian Altschuler |
First Address | Gainesville, FL 32606-7498 |
Second Address | Gainesville, FL 32606-7498 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 08/07/2007 |