# 505 DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** American Institute of Dental Assisting
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710404504
- **Authorized official:** DR. JONAH L FOUTZ DDS (OWNER/CEO)
- **Authorized official phone:** (505) 395-6240

## Contact information

- **Practice address:** 2901 JUAN TABO BLVD NE STE 10, ALBUQUERQUE, NM 87112-1885
- **Practice address phone:** (505) 395-6240
- **Practice address fax:** (505) 214-5132
- **Mailing address:** 2901 JUAN TABO BLVD NE STE 10, ALBUQUERQUE, NM 87112-1885
- **Mailing address phone:** (505) 395-6240
- **Mailing address fax:** (505) 214-5132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DDS662 | NM | Yes |

## Other

- **Enumeration date:** 08/23/2017
- **Last updated:** 07/21/2022