Organization
PARTICIPA, INC. DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET T BRYANT RDH (PRESIDENT)
(800) 886-6751
Entity
Organization
Contact information
Practice address
2434 VALENCIA DR NE, ALBUQUERQUE, NM 87110-4013
(800) 886-6751
(800) 886-6751
Mailing address
2434 VALENCIA DR NE, ALBUQUERQUE, NM 87110-4013
(800) 886-6751
(800) 886-6751
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DD1432
NM
1223D0001X
Public Health Dentistry
DD629
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73799
—
NM
Enumeration date
12/11/2006
Last updated
07/29/2008
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