Individual
DR. LISA KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
8300 CARMEL AVE NE, SUITE 403, ALBUQUERQUE, NM 87122-3147
(505) 299-7678
(505) 299-7670
Mailing address
8300 CARMEL AVE NE, SUITE 403, ALBUQUERQUE, NM 87122-3147
(505) 299-7678
(505) 299-7670
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1752
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84698
—
NM
Enumeration date
10/19/2005
Last updated
07/08/2007
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