Organization
MICHAEL E ROUSSEL DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E ROUSSEL D.M.D. (OWNER)
(505) 881-4365
Entity
Organization
Contact information
Practice address
7127 PROSPECT PL NE, ALBUQUERQUE, NM 87110-4313
(505) 881-4365
(505) 881-8282
Mailing address
7127 PROSPECT PL NE, ALBUQUERQUE, NM 87110-4313
(505) 881-4365
(505) 881-8282
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1422
NM
332BC3200X
Customized Equipment (DME)
1422
NM
Other
Enumeration date
05/20/2015
Last updated
06/30/2015
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