Healthcare Provider Details

I. General information

NPI: 1023866027
Provider Name (Legal Business Name): COMFORT DENTAL ABQ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/07/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 LOMAS BLVD NE # NA
ALBUQUERQUE NM
87110-6233
US

IV. Provider business mailing address

4701 LOMAS BLVD NE
ALBUQUERQUE NM
87110-6233
US

V. Phone/Fax

Practice location:
  • Phone: 505-232-2273
  • Fax:
Mailing address:
  • Phone: 505-232-2273
  • Fax: 505-255-2990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License Number
License Number State

VIII. Authorized Official

Name: MONICA SAAVEDRA
Title or Position: PRACTICE MANAGER
Credential:
Phone: 505-232-2273