Organization
COUNTRY CLUB DENTAL, INC. / DBA: SUNNY SMILE DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANEAL NARENDRA MISTRY DDS (OWNER)
(505) 850-6700
Entity
Organization
Contact information
Practice address
317 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(505) 850-6700
Mailing address
9 CHARING CROSS CT, ROSWELL, NM 88201-0408
(505) 850-6700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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