Organization
SUNDANCE TECHNOLOGIES AND TRAINING CENTER, LLC
Active
Other names
SUNDANCE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP LEPAK LGC, BA, BS (DIRECTOR)
(505) 298-6440
Entity
Organization
Contact information
Practice address
12300 MENAUL BLVD NE, ALBUQUERQUE, NM 87112-2557
(505) 298-6440
(505) 298-7502
Mailing address
PO BOX 11605, ALBUQUERQUE, NM 87192-0605
(505) 298-6440
(505) 298-7502
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
61268
NM
Other
Enumeration date
06/20/2006
Last updated
08/22/2020
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