Familia Dental Los Lunas LLC
NPI #1417377177 in Los Lunas, New Mexico
Provider Information
- NPI Number
- 1417377177
- Entity Type
- Organization
- Organization Name
- Familia Dental Los Lunas LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Apr 21, 2014
- Last Updated
- Oct 15, 2021
Practice Location
- Address
- 1620 MAIN ST NW
- Address 2
- STE D
- City
- Los Lunas
- State
- New Mexico
- ZIP Code
- 87031-4891
- Phone
- (505) 565-0651
Authorized Official
- Name
- MR. BRANDON ALEXANDER TAYLOR, CPCS
- Title
- CREDENTIALING & PAYER RELATIONS MAN
- Phone
- (847) 453-7396
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
| Clinic/Center - Dental — Dental |
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