Organization
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
Active
Parent organization
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
Other names
Rio Rancho Dental Arts
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
Authorized official
KIM WILSON (CREDENTIALING SUPERVISOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
4120 BARBARA LOOP SE, RIO RANCHO, NM 87124-1000
(505) 892-8088
Mailing address
4120 BARBARA LOOP SE, RIO RANCHO, NM 87124-1000
(505) 892-8088
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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