Organization
GALLUP DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL KORY ROWBERRY DDS (OWNER)
(505) 863-8000
Entity
Organization
Contact information
Practice address
1421 US 491, GALLUP, NM 87301
(505) 863-8000
Mailing address
1312 REDROCK DR, GALLUP, NM 87301-5686
(505) 979-2023
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD1562
NM
Other
Enumeration date
05/11/2010
Last updated
05/11/2010
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