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Organization

CHAMISA HILLS FAMILY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN J CANDELARIA DDS (DENTIST OWNER)
(505) 891-3190
Entity
Organization

Contact information

Practice address
1105 GOLF COURSE RD SE, RIO RANCHO, NM 87124
(505) 891-3190
(505) 994-2053
Mailing address
1105 GOLF COURSE RD SE, RIO RANCHO, NM 87124
(505) 891-3190
(505) 994-2053

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2298
NM

Other

Enumeration date
12/30/2015
Last updated
12/30/2015
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