Organization
SUMMIT FAMILY DENTAL OF BERNALILLO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HODGES (OPERATIONS DIRECTOR)
(505) 787-2965
Entity
Organization
Contact information
Practice address
7800 CARR WAY NE STE 105, RIO RANCHO, NM 87144-0900
(505) 327-9161
Mailing address
800 E 30TH ST BLDG 3, FARMINGTON, NM 87401-9407
(505) 327-9161
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
03/08/2021
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