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Organization
ENCINO DENTAL CARE, INC.
Active
Organization
ENCINO DENTAL CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP D RICHARDSON RDH, DOM (OWNER / PRESIDENT)
(505) 843-9636
Entity
Organization
Contact information
Practice address
717 ENCINO PLACE NE SUITE 7, ALBUQUERQUE, NM 87102
(505) 843-9636
(505) 843-6277
Mailing address
717 ENCINO PLACE NE SUITE 7, ALBUQUERQUE, NM 87102
(505) 843-9636
(505) 843-6277
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38759501
—
NM
Enumeration date
07/20/2006
Last updated
08/22/2020
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