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Organization
FAMILIA DENTAL CARLSBAD LLC
Active
Organization
FAMILIA DENTAL CARLSBAD LLC
Active
Other names
Familia Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON ALEXANDER TAYLOR CPCS (CREDENTIALING PAYER RELATIONS MGR)
(847) 453-7396
Entity
Organization
Contact information
Practice address
2330 W PIERCE ST, CARLSBAD, NM 88220-3514
(575) 234-1125
(575) 234-1126
Mailing address
2050 EAST ALGONQUIN RD, SUITE 610, SCHAUMBURG, IL 60173-4144
(888) 988-4066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
05/16/2013
Last updated
06/25/2021
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