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General NPI Number Information
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NPI Number | 1295035095
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Entity Type | Organization
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Legal Business Name | COMFORT DENTAL CENTAL
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 13031 CENTRAL AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-3029
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Country | US
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Telephone | 505-872-2772
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Fax |
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Provider Business Mailing Address
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Address Line | 5820 MENAUL BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3238
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Country | US
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Telephone | 505-872-2772
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Fax |
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | DR. CHRISTOPHER JAMES EHAT
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Credential | D.D.S.
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Telephone | 505-872-2772
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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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