Organization
IMPERIUM DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONGMIN AN DDS (OWNER)
(505) 588-7709
Entity
Organization
Contact information
Practice address
10621 UNSER BLVD NW STE G, ALBUQUERQUE, NM 87114-6487
(505) 588-7709
(505) 212-4119
Mailing address
10621 UNSER BLVD NW STE G, ALBUQUERQUE, NM 87114-6487
(505) 588-7709
(505) 212-4119
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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