# AAA DENTAL

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

## Provider details

- **NPI number:** 1528593001
- **Authorized official:** ERICA L CASTILLO (MANAGER)
- **Authorized official phone:** (505) 554-2262

## Contact information

- **Practice address:** 3803 ATRISCO DR NW, STE-D, ALBUQUERQUE, NM 87120-4956
- **Practice address phone:** (505) 833-1550
- **Mailing address:** 800 JUAN TABO BLVD NE, STE-Q, ALBUQUERQUE, NM 87123-1444
- **Mailing address fax:** (505) 554-2697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DD3595 | NM | Yes |
| 1223G0001X | General Practice Dentistry | DD4343 | NM | — |

## Other

- **Enumeration date:** 04/21/2017
- **Last updated:** 04/21/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 32284756 | — | NM |
| 05 | — | 54001871 | — | NM |