# MODERN DENTAL PROFESSIONALS NEW MEXICO PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Monarch Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861563082
- **Authorized official:** DR. RUSSELL CRAIG TOLER DDS (OWNER)
- **Authorized official phone:** (505) 332-3544

## Contact information

- **Practice address:** 8401 OSUNA RD NE, SUITE B, ALBUQUERQUE, NM 87111-2074
- **Practice address phone:** (505) 332-3544
- **Practice address fax:** (505) 332-4047
- **Mailing address:** 201 SANDPOINTE AVE, 8TH FLOOR, SANTA ANA, CA 92707-5778
- **Mailing address phone:** (505) 332-3544
- **Mailing address fax:** (505) 332-4047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DD2485 | NM | Yes |

## Other

- **Enumeration date:** 11/10/2006
- **Last updated:** 08/22/2020