Organization
TRI DENTAL, LLC
Active
Parent organization
TRI DENTAL, LLC
Other names
Sonrisa Family Dental- Rio Rancho
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI DENTAL, LLC
Authorized official
BRENTON MASON DMD (MEMBER)
(505) 301-4267
Entity
Organization
Contact information
Practice address
2345 SOUTHERN BLVD SE STE B1, RIO RANCHO, NM 87124-3761
(505) 892-0111
Mailing address
2345 SOUTHERN BLVD SE STE B1, RIO RANCHO, NM 87124-3761
(505) 892-0111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50284282
—
NM
Enumeration date
01/11/2022
Last updated
01/11/2022
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