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Organization
ALBUQUERQUE DENTIST OFFICE, LLC
Active
Organization
ALBUQUERQUE DENTIST OFFICE, LLC
Active
Other names
Albuquerque Dentist Office, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLEY HOLLINGSWORTH RYALS DDS (OWNER DOCTOR)
(505) 918-9189
Entity
Organization
Contact information
Practice address
10221 CENTRAL AVE NE, 103, ALBUQUERQUE, NM 87123-2733
(505) 918-9189
(505) 918-9175
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/04/2015
Last updated
03/04/2015
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