Individual
JUSTINE ELISE PONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, MS
Contact information
Practice address
900 YALE BLVD NE, ALBUQUERQUE, NM 87131-0001
(505) 272-6688
Mailing address
3104 HUGHES RD SW, ALBUQUERQUE, NM 87105-5513
(505) 573-8430
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH4764
NM
Other
Enumeration date
12/20/2022
Last updated
04/03/2024
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