Organization
SANTA FE DENTIST OFFICE, LLC
Active
Other names
Santa Fe Dentist Office
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLEY HOLLINGSWORTH RYALS DDS (OWNER DENTIST)
(505) 209-9080
Entity
Organization
Contact information
Practice address
5131 MAIN STREET, 101, SANTA FE, NM 87507
(505) 209-9080
(505) 750-9982
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/04/2016
Last updated
02/07/2022
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