Organization
WEST MESA ORAL AND MAXILLOFACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON ROYBAL (ACCOUNTS RECEIVABLE)
(505) 792-4788
Entity
Organization
Contact information
Practice address
4801 MCMAHON BLVD NW STE 230, ALBUQUERQUE, NM 87114-5478
(505) 792-4788
(505) 792-2533
Mailing address
4801 MCMAHON BLVD NW STE 230, ALBUQUERQUE, NM 87114-5478
(505) 792-4788
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DD1819
NM
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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