Organization
NM SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GALE E JANCSICS RDH (OWNER)
(505) 980-0070
Entity
Organization
Contact information
Practice address
4943 STORY ROCK ST NW, ALBUQUERQUE, NM 87120-3703
(505) 980-0070
Mailing address
4943 STORY ROCK ST NW, ALBUQUERQUE, NM 87120-3703
(505) 980-0070
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD1503
NM
124Q00000X
Dental Hygienist
DH2266
NM
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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