Organization
LISA KING DDS MS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA KING DDS MS (OWNER/PRESIDENT)
(505) 299-7678
Entity
Organization
Contact information
Practice address
8300 CARMEL AVE NE, SUITE 403, ALBUQUERQUE, NM 87122-3147
(505) 266-7678
(505) 299-7070
Mailing address
8300 CARMEL AVE NE, SUITE 403, ALBUQUERQUE, NM 87122-3147
(505) 266-7678
(505) 299-7070
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1752
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84698
—
NM
Enumeration date
09/26/2006
Last updated
08/22/2020
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