Organization
RIO GRANDE ORAL AND MAXILLOFACIAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY R MCGEE DMD (PRESIDENT)
(505) 821-2111
Entity
Organization
Contact information
Practice address
8228 LOUISIANA BLVD NE STE B, ALBUQUERQUE, NM 87113-2427
(505) 821-2111
Mailing address
8228 LOUISIANA BLVD NE STE B, ALBUQUERQUE, NM 87113-2427
(505) 821-2111
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
2698
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2698
DENTAL LICENSE
NM
Enumeration date
03/18/2008
Last updated
03/18/2008
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