Organization
FAMILIA DENTAL CARLSBAD LLC
Active
Other names
Familia Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON ALEXANDER TAYLOR CPCS (CREDENTIALING PAYER RELATIONS MGR)
(847) 453-7396
Entity
Organization
Contact information
Practice address
2330 W PIERCE ST, CARLSBAD, NM 88220-3514
(575) 234-1125
(575) 234-1126
Mailing address
2050 EAST ALGONQUIN RD, SUITE 610, SCHAUMBURG, IL 60173-4144
(888) 988-4066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
05/16/2013
Last updated
06/25/2021
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