Organization
SW MYOFUNCTIONAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRALUZ GONZALEZ RDH (MYOFUNCTIONAL THERAPIST)
(505) 550-6042
Entity
Organization
Contact information
Practice address
5317 DON MIGUEL PL SW, ALBUQUERQUE, NM 87105-5410
(505) 550-6042
Mailing address
5317 DON MIGUEL PL SW, ALBUQUERQUE, NM 87105-5410
(505) 550-6042
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH12281
NM
Other
Enumeration date
05/23/2013
Last updated
06/14/2013
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