Organization
PRAKASH DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAGASHREE PRAKASH DDS (DR.)
(408) 582-2611
Entity
Organization
Contact information
Practice address
3111 EUBANK BLVD NE STE B, ALBUQUERQUE, NM 87111-4875
(505) 296-5458
Mailing address
2136 LAS BRISAS CIR SE, RIO RANCHO, NM 87124-8952
(408) 582-2611
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD3275
NM
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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