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General NPI Number Information
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NPI Number | 1174869093
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Entity Type | Organization
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Legal Business Name | C. H. HILLS DENTAL, INC
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Dates
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Enumeration Date | 12/20/2012
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 1105 GOLF COURSE RD SE BLD A
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City | RIO RANCHO
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State | NM
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Zip | 87124-4733
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Country | US
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Telephone | 505-891-3190
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Fax | 505-994-2053
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Provider Business Mailing Address
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Address Line | 10151 MONTGOMERY BLVD NE BLD 3 SUITE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3670
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Country | US
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Telephone | 505-275-1663
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. FRANK W MONTOYA JR.
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Credential | DDS
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Telephone | 505-275-1663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DD1561
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License Number State | NM
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