Individual
DR. GRANT HANSEN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4041 RIDGE ROCK RD., RIO RANCHO, NM 87124
(505) 891-4510
(505) 962-0803
Mailing address
4041 RIDGE ROCK RD., RIO RANCHO, NM 87124
(505) 891-4510
(505) 962-0803
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD1550
NM
122300000X
Dentist
DD2365
NM
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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