| NPI | 1023474749 |
|---|---|
| Former Legal Business Name | ALBUQUERQUE DENTAL |
| Entity Type | Organization |
| Authorized Contact | WILLIAM CHON GARDNER President 505-266-5881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NM DD-1867) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |