Abq Modern Dental Group, LLC
NPI #1326429622 in Albuquerque, New Mexico
Provider Information
- NPI Number
- 1326429622
- Entity Type
- Organization
- Organization Name
- Abq Modern Dental Group, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 11, 2015
- Last Updated
- Jun 11, 2015
Practice Location
- Address
- 12611 MONTGOMERY BLVD NE
- Address 2
- A-1
- City
- Albuquerque
- State
- New Mexico
- ZIP Code
- 87111-4118
- Phone
- (505) 323-1004
Authorized Official
- Name
- KELLEY HOLLINGSWORTH RYALS, DDS
- Title
- OWNER DENTIST
- Phone
- (505) 323-1004
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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