Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 14103 | TX |
NPI | 1588830780 |
---|---|
Provider Name | Linda Marie Altenhoff |
First Address | Austin, TX 78756-3101 |
Second Address | Austin, TX 78756-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 07/05/2008 |