Organization
PARKWAY DENTAL NM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERA NIEDENS (ACCOUNTANT)
(623) 289-2616
Entity
Organization
Contact information
Practice address
10409 MONTGOMERY PKWY NE STE 201, ALBUQUERQUE, NM 87111-3862
(505) 298-7479
Mailing address
19601 N BLACK CANYON HWY # 201, PHOENIX, AZ 85027-4107
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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