Familia Dental Esp LLC
NPI #1356634703 in Espanola, New Mexico
Provider Information
- NPI Number
- 1356634703
- Entity Type
- Organization
- Organization Name
- Familia Dental Esp LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- May 18, 2011
- Last Updated
- Oct 15, 2021
Practice Location
- Address
- 1508 N RIVERSIDE DR
- City
- Espanola
- State
- New Mexico
- ZIP Code
- 87532-2054
- Phone
- (888) 988-4066
Authorized Official
- Name
- MR. BRANDON ALEXANDER TAYLOR, CPCS
- Title
- CREDENTAILING & PAYER RELATIONS MGR
- Phone
- (847) 453-7396
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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