Grande Dentistry LLC

NPI #1972166262 in Rio Rancho, New Mexico

Provider Information

NPI Number
1972166262
Entity Type
Organization
Organization Name
Grande Dentistry LLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Apr 22, 2019
Last Updated
Oct 30, 2019

Practice Location

Address
2200 GRANDE BLVD SE STE A
ZIP Code
87124-1695
Phone
(505) 891-1500

Authorized Official

Name
FAITH GASKINS
Title
DIRECTOR OF CREDENTIALING
Phone
(972) 869-3789

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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