Organization
ENCHANTED HILLS DENTISTRY, PROFESSIONAL CORPORATION
Active
Other names
Enchanted Hills Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO HERREJON-RUIZ DMD (OWNER DOCTOR)
(505) 867-8444
Entity
Organization
Contact information
Practice address
470 NEW MEXICO 528, A, BERNALILLO, NM 87004
(505) 867-8444
(505) 867-3186
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/05/2015
Last updated
03/31/2015
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