Organization
DARREN HALTOM SPECIALTY PARTNERS OF NM II, LLC
Active
Other names
Haltom Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRYSTAL RICHARDSON (DIRECTOR OF RCM)
(214) 934-7995
Entity
Organization
Contact information
Practice address
10433 LAGRIMA DE ORO, ALBUQUERQUE, NM 87111
(505) 299-4458
(505) 299-4450
Mailing address
10433 LAGRIMA DE ORO RD NE, ALBUQUERQUE, NM 87111-3727
(505) 299-4458
(505) 299-4450
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD2090
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336138684
ENVOLVE BENEFIT OPTIONS
—
05
—
31672752
—
NM
Enumeration date
07/22/2014
Last updated
12/01/2025
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