Individual
BONGMIN AN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3211 COORS BLVD SW STE D2, ALBUQUERQUE, NM 87121-5255
(505) 336-7451
Mailing address
6205 CASA BLANCA NW, ALBUQUERQUE, NM 87120-3280
(541) 301-7609
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD5580
NM
Other
Enumeration date
05/11/2007
Last updated
02/18/2026
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