Organization
NEW MEXICO DEPARTMENT OF HEALTH
Active
Other names
New Mexico Department of Health, Special Needs Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM COPELAND (DDSD DIRECTOR)
(505) 660-3453
Entity
Organization
Contact information
Practice address
7905 MARBLE AVE NE, ALBUQUERQUE, NM 87110-7886
(505) 232-5710
(505) 232-5720
Mailing address
7905 MARBLE AVE. NE, ALBUQUERQUE, NM 87110-7886
(505) 232-5710
(505) 232-5720
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD1302
NM
1223G0001X
General Practice Dentistry
DD3457
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89623
—
NM
Enumeration date
03/23/2007
Last updated
07/09/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us