JIM R. FUQUA

ALBUQUERQUE, NM
NPI1497848188
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: NC  3274)
Enumeration Date2006-10-02
Last Update Date2007-07-08
Business Address
Dr. JIM R. FUQUA DDS
ALBUQUERQUE INDIAN HEALTH SERVICE DENTAL CLINIC 9169 COORS ROAD NW
ALBUQUERQUE, NM 87193
Phone number: 505-346-2306
Mailing Address
Dr. JIM R. FUQUA DDS
PO BOX 411957
MELBOURNE, FL 32941-1957
Phone number: 321-638-1219
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