New Mexico Professional Dental Associates, INC
NPI #1255764650 in Rio Rancho, New Mexico
Provider Information
- NPI Number
- 1255764650
- Entity Type
- Organization
- Organization Name
- New Mexico Professional Dental Associates, INC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 21, 2013
- Last Updated
- Aug 21, 2013
Practice Location
- Address
- 4120 BARBARA LOOP SE
- City
- Rio Rancho
- State
- New Mexico
- ZIP Code
- 87124-1000
- Phone
- (505) 892-8088
Authorized Official
- Name
- KIM WILSON
- Title
- CREDENTIALING SUPERVISOR
- Phone
- (217) 540-5170
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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