Organization
RIO RANCHO DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY A WHITLOW (OFFICE MANAGER)
(505) 994-9693
Entity
Organization
Contact information
Practice address
1316 JACKIE RD SE STE 300, RIO RANCHO, NM 87124-1045
(505) 994-9693
Mailing address
1316 JACKIE RD SE STE 300, RIO RANCHO, NM 87124-1045
(505) 994-9693
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD1498
NM
Other
Enumeration date
10/19/2009
Last updated
02/17/2014
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