Individual
DR. LIONEL MICHAEL CANDELARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7308 WADI MUSA DR NE, ALBUQUERQUE, NM 87122-3346
(505) 321-8291
Mailing address
6800 MONTGOMERY BLVD NE, SUITE A, ALBUQUERQUE, NM 87109-1405
(505) 881-1130
(505) 881-2081
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DD1894
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM100139
MEDICARE PTAN
NM
Enumeration date
03/08/2006
Last updated
01/24/2025
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