Individual
CARISSA JAEL GREINEL-BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7007 WYOMING BLVD NE STE B2, ALBUQUERQUE, NM 87109-3982
(505) 821-1430
(505) 821-1442
Mailing address
7007 WYOMING BLVD NE STE B2, ALBUQUERQUE, NM 87109-3982
(505) 821-1430
(505) 821-1442
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DD3005
NM
1223G0001X
General Practice Dentistry
Primary
14244
MD
Other
Enumeration date
09/30/2008
Last updated
04/15/2016
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