Organization
CORRECTIONAL HEALTHCARE COMPANIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA G SALAZAR (REGIONAL DIRECTOR OF OPERATIONS)
(505) 898-3884
Entity
Organization
Contact information
Practice address
100 JOHN DANTIS RD SW, ALBUQUERQUE, NM 87151-0100
(505) 839-8855
Mailing address
6200 S SYRACUSE WAY STE 400, GREENWOOD VILLAGE, CO 80111-4737
(505) 898-3884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD1292
NM
Other
Enumeration date
08/20/2010
Last updated
08/20/2010
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