Individual
DR. JONAH LEROY FOUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5901 WYOMING BLVD NE, ALBUQUERQUE, NM 87109-3838
(505) 821-4422
Mailing address
7120 CALLE ALEGRIA NE, ALBUQUERQUE, NM 87113-1368
(816) 550-8494
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3662
NM
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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