Organization
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
Active
Parent organization
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
Other names
Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
8400 OSUNA RD NE STE 4A, ALBUQUERQUE, NM 87111-2071
(505) 294-4700
Mailing address
8400 OSUNA RD NE STE 4A, ALBUQUERQUE, NM 87111-2071
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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