Organization
KID'S CHOICE DENTAL, INC
Active
Other names
Family Choice Dental, Kid's Choice Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVID NOYES JR. DDS (PRESIDENT)
(505) 352-5439
Entity
Organization
Contact information
Practice address
120 98TH ST NW STE C3, ALBUQUERQUE, NM 87121-9021
(505) 352-5439
(505) 821-8041
Mailing address
120 98TH ST NW STE C3, ALBUQUERQUE, NM 87121-9021
(505) 352-5439
(505) 836-7533
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2523
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1768244
UNITED CONCORDIA
NM
05
—
51004844
—
NM
Enumeration date
07/25/2011
Last updated
07/29/2020
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