Individual
CRISMON ALEXANDER GOUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5800 LOMAS BLVD NE, ALBUQUERQUE, NM 87110
(505) 268-6388
(505) 254-2461
Mailing address
5800 LOMAS BLVD NE, ALBUQUERQUE, NM 87110-6539
(909) 838-3260
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
64018
CA
1223G0001X
General Practice Dentistry
Primary
DD5023
NM
Other
Enumeration date
10/28/2014
Last updated
07/18/2019
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