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Organization
WEST MESA ORAL AND MAXILLOFACIAL SURGERY PC
Active
Organization
WEST MESA ORAL AND MAXILLOFACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON ROYBAL (ACCOUNTS RECEIVABLE)
(505) 792-4788
Entity
Organization
Contact information
Practice address
4801 MCMAHON BLVD NW STE 230, ALBUQUERQUE, NM 87114-5478
(505) 792-4788
(505) 792-2533
Mailing address
4801 MCMAHON BLVD NW STE 230, ALBUQUERQUE, NM 87114-5478
(505) 792-4788
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DD1819
NM
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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