Organization
JUST FOR GRINS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH PRISHKULNIK DDS (OWNER)
(505) 428-7878
Entity
Organization
Contact information
Practice address
1498 S SAINT FRANCIS DR, SANTA FE, NM 87505-4038
(505) 428-7878
Mailing address
490B W ZIA RD, SANTA FE, NM 87505-7008
(505) 428-7878
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DD2707
NM
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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