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Individual

JOHN J CANDELARIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
120 S 9TH ST, BELEN, NM 87002-3102
(505) 861-1013
Mailing address
6628 DEERBOURNE RD NW, ALBUQUERQUE, NM 87114-4726
(505) 899-9772

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2298
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
26985579
NM
Enumeration date
10/12/2005
Last updated
07/08/2007
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