Organization
JUST CLEAN SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA M RIORDAN RDH (MANAGER/DENTAL HYGIENIST)
(505) 565-0609
Entity
Organization
Contact information
Practice address
1204 MAIN ST NE, SUITE B, LOS LUNAS, NM 87031-7409
(505) 565-0609
(505) 565-0709
Mailing address
1204 MAIN ST NE, SUITE B, LOS LUNAS, NM 87031-7409
(505) 565-0609
(505) 565-0709
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1503
NM
124Q00000X
Dental Hygienist
Primary
DH-373
NM
Other
Enumeration date
11/02/2010
Last updated
03/27/2011
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