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General NPI Number Information
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NPI Number | 1023966462
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Entity Type | Organization
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Legal Business Name | DYER'S DENTAL GROUP, PC
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 3900 EUBANK BLVD NE STE 17
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3427
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Country | US
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Telephone | 402-505-6843
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Fax |
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Provider Business Mailing Address
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Address Line | 6606 S 168TH ST STE 100
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City | OMAHA
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State | NE
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Zip | 68135-5420
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Country | US
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Telephone | 402-505-6843
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Fax |
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Authorized Official
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Title or Position | HR ADMIN
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Name | SHAYLA MOORE
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Credential |
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Telephone | 402-505-6843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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