Individual
LEEANN NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3569 ZAFARANO DR, SANTA FE, NM 87507-2618
(505) 986-8000
Mailing address
309 DELGADO ST, SANTA FE, NM 87501-2729
(973) 908-5994
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D012173
AZ
1223G0001X
General Practice Dentistry
D012173
AZ
1223G0001X
General Practice Dentistry
DB-2024-0400
NM
Other
Enumeration date
06/19/2024
Last updated
01/03/2025
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