Individual
JON MICHAEL BOATMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
2320 TUCKER RD, ALBUQUERQUE, NM 87131-0001
(505) 272-4513
Mailing address
6501 SAN ANTONIO DR NE UNIT 602, ALBUQUERQUE, NM 87109-4139
(505) 459-5871
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH3760
NM
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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