Organization
NEW MEXICO DENTISTRY PRADA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. APRIL THACKER MBA (MANAGER OF PAYER RELATIONS)
(702) 291-2031
Entity
Organization
Contact information
Practice address
6211 4TH ST NW STE 1, ALBUQUERQUE, NM 87107-5700
(702) 291-2031
(702) 984-7566
Mailing address
2250 S RANCHO DR STE 205, LAS VEGAS, NV 89102-4456
(702) 291-2031
(702) 984-7566
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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