770 Broadmoor Rio Rancho Professional LLC
NPI #1841890373 in Rio Rancho, New Mexico
Provider Information
- NPI Number
- 1841890373
- Entity Type
- Organization
- Organization Name
- 770 Broadmoor Rio Rancho Professional LLC
- Primary Specialty
- Dentist
- Enumeration Date
- Oct 26, 2020
- Last Updated
- Oct 26, 2020
Practice Location
- Address
- 770 BROADMOOR BLVD NE
- City
- Rio Rancho
- State
- New Mexico
- ZIP Code
- 87124-3442
- Phone
- (505) 891-0554
Authorized Official
- Name
- AMY GAMBOA
- Title
- OFFICE MANAGER
- Phone
- (505) 891-0554
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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