Organization
SMALL FRY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARDO VALDA DDS (OWNER)
(505) 870-6128
Entity
Organization
Contact information
Practice address
1401 LINDA DR, GALLUP, NM 87301-5615
(505) 870-6128
Mailing address
1401 LINDA DR, GALLUP, NM 87301-5615
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2150
NM
Other
Enumeration date
08/16/2007
Last updated
08/16/2007
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