Organization
NEW MEXICO PROFESSIONAL DENTAL
Active
Parent organization
NEW MEXICO PROFESSIONAL DENTAL
Other names
North Side Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW MEXICO PROFESSIONAL DENTAL
Authorized official
MARIE KUHL (CREDENTIALING MANAGER)
(217) 540-5100
Entity
Organization
Contact information
Practice address
806 CALLE MEJIA, SANTA FE, NM 87501-1405
(217) 540-5100
Mailing address
806 CALLE MEJIA, SANTA FE, NM 87501-1405
(217) 540-5100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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