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Organization
SANDIA PEAK DENTAL, LLC
Active
Organization
SANDIA PEAK DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANSEN DONOGHUE (MEMBER)
(505) 298-6732
Entity
Organization
Contact information
Practice address
8000 EUBANK BLVD NE, ALBUQUERQUE, NM 87122-3225
(505) 298-6732
(505) 275-9976
Mailing address
8000 EUBANK BLVD NE, ALBUQUERQUE, NM 87122-3225
(505) 298-6732
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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