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
- City
- Rio Rancho
- State
- New Mexico
- 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 Practice — General Practice |
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