Individual
DR. SHANE GREGORY KROHNFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6425 HOLLY AVE NE, ALBUQUERQUE, NM 87113-2474
(505) 828-2020
Mailing address
6425 HOLLY AVE NE, ALBUQUERQUE, NM 87113-2474
(505) 828-2020
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DD4823
NM
1223G0001X
General Practice Dentistry
103623
CA
1223G0001X
General Practice Dentistry
Primary
DD4823
NM
Other
Enumeration date
12/08/2017
Last updated
11/02/2022
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