# ORAL AND MAXILLOFACIAL SURGERY ASSOCIATE OF NEW MEXICO, P.A.

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

## Provider details

- **NPI number:** 1689876963
- **Authorized official:** JOHN C MITCHELL D.D.S. (MANAGING PARTNER)
- **Authorized official phone:** (505) 881-1130

## Contact information

- **Practice address:** 6800 MONTGOMERY BLVD NE, SUITE A, ALBUQUERQUE, NM 87109-1405
- **Practice address phone:** (505) 881-1130
- **Mailing address:** 6800 MONTGOMERY BLVD NE, SUITE A, ALBUQUERQUE, NM 87109-1405
- **Mailing address phone:** (505) 881-1130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 02-256180-00-3 | NM | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 07/08/2009