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1467007427
JACOB KUALAPAI
LOS RANCHOS, NM
NPI
1467007427
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: NM DH2912)
Enumeration Date
2019-08-07
Last Update Date
2019-08-07
Business Address
JACOB KUALAPAI RDH, CDHC
1776 MONTANO RD NW
LOS RANCHOS, NM 87107-3245
Phone number: 505-615-0951
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Mailing Address
JACOB KUALAPAI RDH, CDHC
1080 SAND DUNE RD NE
RIO RANCHO, NM 87144-8051
Phone number: 505-503-3544
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