Individual
DR. JENNIFER BODZIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
UNM RESIDENCY CLINIC, 1801 CAMINO DE SALUD, ALBUQUERQUE, NM 87102
(505) 925-4031
Mailing address
1537 32ND CIR SE, RIO RANCHO, NM 87124-1967
(505) 720-2019
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901017490
MI
122300000X
Dentist
Primary
DD2048
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64528766
—
NM
Enumeration date
04/11/2007
Last updated
07/05/2019
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