Alfred Matthew Macaltao

Individual provider Active NPI Dental Hygienist · Crownpoint, NM

NPI 1699299693 · NPPES record last updated Aug 1, 2017

Key facts

NPI
1699299693
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
025404 (NY)
Practice address
Junction of Highway 371 Navajo Route 9
Crownpoint, NM 87313-0358
Phone
(505) 786-5291
NPI assigned
Aug 1, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 025404 NY Yes

Addresses

Primary practice location

Junction of Highway 371 Navajo Route 9
Crownpoint, NM 87313-0358

Mailing address

22 N San Mateo Dr Apt 107
San Mateo, CA 94401-2804
Phone (917) 697-1269

Other providers in Crownpoint, NM

All providers in Crownpoint, NM · Dental Hygienist in New Mexico

Sources for this page

Verify at the official NPI Registry.