Cdb 550 LLC

NPI #1174992564 in Bernalillo, New Mexico

Provider Information

NPI Number
1174992564
Entity Type
Organization
Organization Name
Cdb 550 LLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Sep 16, 2015
Last Updated
Sep 16, 2015

Practice Location

Address
120 E HIGHWAY 550
ZIP Code
87004-5967
Phone
(505) 550-0503

Authorized Official

Name
DR. JONAH L FOUTZ, DD3662
Title
OWNER
Phone
(505) 550-0305

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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