Individual
DR. DOUGLAS PAUL CHISHOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2010 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87112-3306
(505) 237-2273
Mailing address
2010 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87112-3306
(505) 237-2273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3317
NM
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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