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General NPI Number Information
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NPI Number | 1003300393
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Entity Type | Organization
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Legal Business Name | NAPA DENTAL MANAGEMENT LLC
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 06/18/2023
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Provider Practice Location Address
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Address Line | 10820 COMANCHE RD NE STE D
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3983
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Country | US
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Telephone | 505-323-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 10820 COMANCHE RD NE STE D
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3983
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Country | US
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Telephone | 505-323-7700
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KARTIK ANTANI
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Credential | DMD
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Telephone | 848-565-5070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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