Individual
GOLDEN OFOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
MSC06 3500 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 925-4031
(505) 925-4030
Mailing address
MSC06 3500 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 925-4031
(505) 925-4030
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
39239
TX
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TD-00-161
NM
Other
Enumeration date
04/09/2022
Last updated
05/12/2023
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