# SOUTHWEST ORAL AND MAXILLOFACIAL SURGEONS LLC

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

## Provider details

- **NPI number:** 1629615851
- **Authorized official:** WAI PONG NG DMD (OWNER)
- **Authorized official phone:** (505) 797-3530

## Contact information

- **Practice address:** 5900 CUBERO DR NE STE A, ALBUQUERQUE, NM 87109-3879
- **Practice address phone:** (505) 797-3530
- **Practice address fax:** (505) 797-2155
- **Mailing address:** 5900 CUBERO DR NE STE A, ALBUQUERQUE, NM 87109-3879
- **Mailing address phone:** (505) 797-3530
- **Mailing address fax:** (505) 797-2155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/06/2019
- **Last updated:** 12/06/2019