Healthcare Provider Details

I. General information

NPI: 1790840429
Provider Name (Legal Business Name): DAVID A. DENGLER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5305 CAMINO ARBUSTOS NE
ALBUQUERQUE NM
87111-6723
US

IV. Provider business mailing address

12231 ACADEMY RD. NE STE 301, #282
ALBUQUERQUE NM
87111-7239
US

V. Phone/Fax

Practice location:
  • Phone: 505-298-7407
  • Fax: 505-266-2641
Mailing address:
  • Phone: 505-298-7407
  • Fax: 505-266-2641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number650
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number650
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: