Organization
JEFFREY J SUPPLE DMD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY J SUPPLE DMD (OWNER)
(505) 883-3933
Entity
Organization
Contact information
Practice address
6800 MONTGOMERY BLVD NE, SUITE G, ALBUQUERQUE, NM 87109-1405
(505) 883-3933
(505) 883-3934
Mailing address
6800 MONTGOMERY BLVD NE, SUITE G, ALBUQUERQUE, NM 87109-1405
(505) 883-3933
(505) 883-3934
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD1731
NM
Other
Enumeration date
10/05/2006
Last updated
08/22/2020
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