Pearly Whites Dental Office, Inc.

NPI #1811009855 in Rio Rancho, New Mexico

Provider Information

NPI Number: 1811009855
Entity Type: Organization
Organization Name: Pearly Whites Dental Office, Inc.
Primary Specialty: Dentist
Enumeration Date: Aug 31, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 4041 BARBARA LOOP SE
Address 2: SUITE A
City: Rio Rancho
State: New Mexico
ZIP Code: 87124-1065
Phone: (505) 891-1500

Authorized Official

Name: SHIRLEY ANN PROFAZI, RDH
Title: OWNER
Phone: (505) 891-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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