Organization
TAOS DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN NYLUND DDS (DENTIST)
(575) 758-8654
Entity
Organization
Contact information
Practice address
1392 WEIMER RD, TAOS, NM 87571-5307
(575) 758-8654
(575) 737-0970
Mailing address
1392 WEIMER RD, TAOS, NM 87571-5307
(575) 758-8654
(575) 737-0970
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DD1078
NM
1223G0001X
General Practice Dentistry
Primary
DD3407
NM
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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