Individual
JADA DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3569 ZAFARANO DR, SANTA FE, NM 87507-2618
(505) 986-8000
Mailing address
106 RANCHO VIEJO BLVD, SANTA FE, NM 87508-1553
(919) 923-2721
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9476
NC
122300000X
Dentist
Primary
DD5569
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/09/2012
Last updated
04/20/2022
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