Individual
ROBERT C SUPPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8401 OSUNA RD NE, SUITE C, ALBUQUERQUE, NM 87111-2074
(505) 294-8869
(505) 292-2071
Mailing address
8401 OSUNA RD NE, SUITE C, ALBUQUERQUE, NM 87111-2074
(505) 294-8869
(505) 292-2071
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1365
NM
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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