Individual
DHARA PELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4600 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1210
(505) 727-4659
Mailing address
2 TRIGO RD, PLACITAS, NM 87043-8691
(678) 876-6424
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT8989
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
516062240
NM DRIVER'S LICENCE
—
Enumeration date
02/11/2019
Last updated
02/11/2019
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