Organization
ROSS FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY ROSS DDS (OWNER)
(505) 293-7441
Entity
Organization
Contact information
Practice address
10330 MONTGOMERY BLVD NE, SUITE A, ALBUQUERQUE, NM 87111-3600
(505) 293-7441
Mailing address
10330 MONTGOMERY BLVD NE, SUITE A, ALBUQUERQUE, NM 87111-3600
(505) 293-7441
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2625
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104923085
INDIVIDUAL NPI
NM
01
—
1124125091
INDIVIDUAL NPI
NM
Enumeration date
03/10/2011
Last updated
03/10/2011
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