Individual
DR. NAGASHREE BALUR PRAKASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1217 1ST ST NW, ALBUQUERQUE, NM 87102-1529
(505) 766-5197
Mailing address
9204 MENAUL BLVD NE STE 3, ALBUQUERQUE, NM 87112-2201
(505) 299-6112
(505) 299-7718
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
54839
CA
1223G0001X
General Practice Dentistry
Primary
DD3275
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52932532
—
NM
Enumeration date
06/26/2008
Last updated
07/22/2020
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