# ENCINO DENTAL CARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225058761
- **Authorized official:** PHILLIP D RICHARDSON RDH, DOM (OWNER / PRESIDENT)
- **Authorized official phone:** (505) 843-9636

## Contact information

- **Practice address:** 717 ENCINO PLACE NE SUITE 7, ALBUQUERQUE, NM 87102
- **Practice address phone:** (505) 843-9636
- **Practice address fax:** (505) 843-6277
- **Mailing address:** 717 ENCINO PLACE NE SUITE 7, ALBUQUERQUE, NM 87102
- **Mailing address phone:** (505) 843-9636
- **Mailing address fax:** (505) 843-6277

## Taxonomy

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

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 38759501 | — | NM |