Individual
KAMALA POUDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1508 N RIVERSIDE DR, ESPANOLA, NM 87532-2064
(505) 753-0544
Mailing address
21 ZUNI ST, LOS ALAMOS, NM 87544-2647
(248) 224-9754
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DB-2024-0382
NM
Other
Enumeration date
02/16/2024
Last updated
11/27/2024
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