NPI | 1326429622 |
---|---|
Doing Business As | ABQ MODERN DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | KELLEY HOLLINGSWORTH RYALS Owner Dentist 505-323-1004 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2015-06-11 |
Last Update Date | 2015-06-11 |