Organization
AIDA NEW MEXICO CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONAH L FOUTZ DDS (OWNER)
(505) 395-6240
Entity
Organization
Contact information
Practice address
2901 JUAN TABO BLVD NE STE 10, ALBUQUERQUE, NM 87112-1885
(505) 395-6240
Mailing address
2901 JUAN TABO BLVD NE STE 10, ALBUQUERQUE, NM 87112-1885
(505) 395-6240
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3662
NM
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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