Individual
DR. STACEY M REISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MDENTSC
Contact information
Practice address
2800 COORS BLVD NW STE A, ALBUQUERQUE, NM 87120-1204
(505) 352-1166
Mailing address
5110 EAKES RD NW, LOS RANCHOS, NM 87107-5538
(203) 247-1456
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD4909
NM
Other
Enumeration date
04/30/2015
Last updated
04/17/2020
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