Individual
LEILANI KIYOKO TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6101 CANDELARIA RD NE, ALBUQUERQUE, NM 87110-2500
(505) 883-0005
Mailing address
1266 BONA TERRA LOOP NW, ALBUQUERQUE, NM 87114-1983
(510) 847-6244
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
25578
TX
122300000X
Dentist
4196
NM
122300000X
Dentist
Primary
56715
CA
Other
Enumeration date
07/17/2008
Last updated
11/07/2014
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