| NPI | 1154804755 |
|---|---|
| Doing Business As | ABQ PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | EBONIE GONZALES Credentialing Manager 505-850-3769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2024-03-25 |