Organization
DENTISTRY ON ST. MICHAELS LLC
Active
Other names
Santa Fe Place Dental Practice LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE GARRIS (SENIOR PRACTICE MANAGER)
(505) 982-4867
Entity
Organization
Contact information
Practice address
435 SAINT MICHAELS DR STE B201, SANTA FE, NM 87505-7681
(505) 982-4867
(505) 424-8535
Mailing address
435 SAINT MICHAELS DR STE B201, SANTA FE, NM 87505-7681
(505) 982-4867
(505) 424-8535
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183394
UNITED CONCORDIA
NM
Enumeration date
05/08/2008
Last updated
04/30/2019
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