Healthcare Provider Details

I. General information

NPI: 1932228228
Provider Name (Legal Business Name): TERESA I RAMOS-BELFON DOM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA BELFON RDH

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 MONTGOMERY BLVD NE SUITE F
ALBUQUERQUE NM
87109-1405
US

IV. Provider business mailing address

6800 MONTGOMERY BLVD NE SUITE F
ALBUQUERQUE NM
87109-1405
US

V. Phone/Fax

Practice location:
  • Phone: 505-883-7262
  • Fax:
Mailing address:
  • Phone: 505-883-9598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1292
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number967
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: