Organization
AU CROWN ENTERPRISES LLC
Active
Other names
Carabelli Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEON AHGHAR DDS (SOLE OWNER)
(505) 553-1332
Entity
Organization
Contact information
Practice address
824 N MAIN ST, ROSWELL, NM 88201-4969
(575) 622-4455
Mailing address
824 N MAIN ST, ROSWELL, NM 88201-4969
(575) 622-4455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DD4275
NM
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/27/2018
Last updated
04/11/2024
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