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
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 PracticeGeneral Practice

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