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Organization
TILEY'S TOOTHFAIRIES
Active
Organization
TILEY'S TOOTHFAIRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY ESPINOSA (OFFICE MANAGER)
(505) 294-5500
Entity
Organization
Contact information
Practice address
8012 MENAUL BLVD NE, ALBUQUERQUE, NM 87110-4608
(505) 294-5500
Mailing address
8012 MENAUL BLVD NE, ALBUQUERQUE, NM 87110-4608
(505) 294-5500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NM2547
NM
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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