Organization
PEPPERMINT DENTAL-SAN MATEO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PU (CFO)
(972) 869-3789
Entity
Organization
Contact information
Practice address
333 SAN MATEO BLVD SE UNIT A, ALBUQUERQUE, NM 87108-2919
(505) 268-8888
Mailing address
7301 STATE HIGHWAY 161 STE 198, IRVING, TX 75039-2880
(972) 869-3789
(972) 869-3791
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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