# PEDIATRIC DENTAL ASSOCIATES OF NM PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** smiles for kids
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609176569
- **Authorized official:** DR. SPENCER JOHN TASKER DMD (OWNER/DENTIST)
- **Authorized official phone:** (505) 892-9010

## Contact information

- **Practice address:** 8501 CANDELARIA RD NE, NE SUITE D-2, ALBUQUERQUE, NM 87112-1034
- **Practice address phone:** (505) 299-9606
- **Practice address fax:** (505) 299-9740
- **Mailing address:** 8501 CANDELARIA RD NE, NE SUITE D-2, ALBUQUERQUE, NM 87112-1034
- **Mailing address phone:** (505) 299-9606
- **Mailing address fax:** (505) 299-9740

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | PT0111434 | NM | Yes |

## Other

- **Enumeration date:** 10/26/2010
- **Last updated:** 10/26/2010