Individual
WALTICE BENJAMIN HAM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4101 MORRIS ST NE, SUITE G, ALBUQUERQUE, NM 87111-3605
(505) 292-4000
(505) 271-2426
Mailing address
4101 MORRIS ST NE, SUITE G, ALBUQUERQUE, NM 87111-3605
(505) 292-4000
(505) 271-2426
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NM1486
NM
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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