Organization
SMILES FOR NM KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONIE MARIE BOGDAN (BILLIBNG SPECIALIST)
(505) 850-3769
Entity
Organization
Contact information
Practice address
8201 GOLF COURSE RD NW, ALBUQUERQUE, NM 87120-5842
(505) 892-9010
Mailing address
8201 GOLF COURSE RD NW, ALBUQUERQUE, NM 87120-5842
(505) 892-9010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/26/2013
Last updated
01/06/2014
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