Healthcare Provider Details

I. General information

NPI: 1811008949
Provider Name (Legal Business Name): SANCHEZ DENTAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 CARDENAS DR NE
ALBUQUERQUE NM
87110
US

IV. Provider business mailing address

1109 CARDENAS DR NE
ALBUQUERQUE NM
87110
US

V. Phone/Fax

Practice location:
  • Phone: 505-268-2741
  • Fax: 505-266-7383
Mailing address:
  • Phone: 505-268-2741
  • Fax: 505-266-7383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREGORY T SANCHEZ
Title or Position: OWNER PRESIDENT
Credential: DDS
Phone: 505-268-2741