Organization
BOSQUE SMILES DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAE YANG (OWNER)
(714) 845-8500
Entity
Organization
Contact information
Practice address
5600 COORS BLVD NW STE G4, ALBUQUERQUE, NM 87120-1877
(505) 431-9740
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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