Individual
JERREN MICHAEL ALCALDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
(505) 368-6360
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
(505) 368-6360
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416334
VA
Other
Enumeration date
04/13/2018
Last updated
02/06/2019
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