Individual
DR. JOHN RYAN JEPPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4411 SAN MATEO BLVD NE STE E1, ALBUQUERQUE, NM 87109
(505) 872-4867
(505) 872-9380
Mailing address
4411 SAN MATEO BLVD NE STE E1, ALBUQUERQUE, NM 87109-2000
(505) 872-4867
(972) 590-8809
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5809
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/29/2016
Last updated
09/13/2019
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