# TRI DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRI DENTAL, LLC
- **Other names:** Sonrisa Family Dental- Rio Rancho
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124779210
- **Legal business name:** TRI DENTAL, LLC
- **Authorized official:** BRENTON MASON DMD (MEMBER)
- **Authorized official phone:** (505) 301-4267

## Contact information

- **Practice address:** 2345 SOUTHERN BLVD SE STE B1, RIO RANCHO, NM 87124-3761
- **Practice address phone:** (505) 892-0111
- **Mailing address:** 2345 SOUTHERN BLVD SE STE B1, RIO RANCHO, NM 87124-3761
- **Mailing address phone:** (505) 892-0111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/11/2022
- **Last updated:** 01/11/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 50284282 | — | NM |