Provider Demographics
NPI:1194042945
Name:ALTMAN, DAVID ABRAHAM (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ABRAHAM
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 S QUAIL CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-1660
Mailing Address - Country:US
Mailing Address - Phone:954-270-9427
Mailing Address - Fax:
Practice Address - Street 1:2609 N KANSAS EXPY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-1114
Practice Address - Country:US
Practice Address - Phone:417-501-8922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN191311223G0001X
MO20110103711223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program