Healthcare Provider Details

I. General information

NPI: 1336071232
Provider Name (Legal Business Name): BETTY NAA AWULA ABBEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N MAIN ST
ROSWELL NM
88201-6554
US

IV. Provider business mailing address

13818 E 51ST ST APT 421
TULSA OK
74134-6754
US

V. Phone/Fax

Practice location:
  • Phone: 575-208-1520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDB-2026-0174
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: