Organization
SOUTHWEST ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY L JONES M.D.,D.D.S. (OWNER)
(505) 797-3530
Entity
Organization
Contact information
Practice address
5900 CUBERO DR NE STE A, ALBUQUERQUE, NM 87109-3879
(505) 797-3530
(505) 797-2155
Mailing address
5900 CUBERO DR NE STE A, ALBUQUERQUE, NM 87109-3879
(505) 797-3530
(505) 797-2155
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DD1094
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E1446
—
NM
Enumeration date
05/01/2008
Last updated
12/06/2011
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