Organization
CRDS
Active
Parent organization
ALBUQUERQUE MODERN DENTISTRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALBUQUERQUE MODERN DENTISTRY
Authorized official
DR. MICHAEL ROSS CONNER DDS (DENTIST)
(575) 642-4779
Entity
Organization
Contact information
Practice address
2800 COORS BLVD NW STE A, ALBUQUERQUE, NM 87120-1204
(505) 350-1166
(505) 352-2805
Mailing address
2800 COORS BLVD NW STE A, ALBUQUERQUE, NM 87120-1204
(505) 350-1166
(505) 352-2805
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD4332
NM
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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