Organization
NM SMILES GO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GALE JANCSICS (EXECUTIVE DIRECTOR)
(505) 836-7337
Entity
Organization
Contact information
Practice address
8604 MESA TOP RD NW, ALBUQUERQUE, NM 87120-4310
(505) 836-7337
Mailing address
8604 MESA TOP RD NW, ALBUQUERQUE, NM 87120-4310
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
1503
NM
124Q00000X
Dental Hygienist
2266
NM
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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