Northrise Dental LLC
NPI #1437622503 in Las Cruces, New Mexico
Provider Information
- NPI Number
- 1437622503
- Entity Type
- Organization
- Organization Name
- Northrise Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 10, 2019
- Last Updated
- Jan 10, 2019
Practice Location
- Address
- 2540 N TELSHOR BLVD STE E
- City
- Las Cruces
- State
- New Mexico
- ZIP Code
- 88011-8201
- Phone
- (575) 521-9375
Authorized Official
- Name
- DR. JARED WALLIS, DDS
- Title
- DENTIST/OWNER
- Phone
- (575) 521-9375
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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