Organization
TASKER HATCH ROWAN LLC
Active
Parent organization
SMILES FOR NM KIDS
Other names
smiles for nm kids
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMILES FOR NM KIDS
Authorized official
EBONIE GONZALES CREDS MGR (CREDENTIALING MANAGER)
(505) 850-3769
Entity
Organization
Contact information
Practice address
9201 EAGLE RANCH RD NW FL 3, ALBUQUERQUE, NM 87114-6440
(505) 892-9010
(505) 899-4804
Mailing address
325 S HIGLEY #130, GILBERT, AZ 85296
(505) 850-3769
(505) 890-2949
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NM
Other
Enumeration date
01/28/2011
Last updated
06/16/2022
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