Organization
MODERN DENTAL PROFESSIONALS NEW MEXICO PC
Active
Other names
Monarch Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL CRAIG TOLER DDS (OWNER)
(505) 332-3544
Entity
Organization
Contact information
Practice address
8401 OSUNA RD NE, SUITE B, ALBUQUERQUE, NM 87111-2074
(505) 332-3544
(505) 332-4047
Mailing address
201 SANDPOINTE AVE, 8TH FLOOR, SANTA ANA, CA 92707-5778
(505) 332-3544
(505) 332-4047
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2485
NM
Other
Enumeration date
11/10/2006
Last updated
08/22/2020
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