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General NPI Number Information
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NPI Number | 1528088903
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Entity Type | Individual
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Provider Name | FELIX C. MADRID D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2345 SOUTHERN BLVD SE STE B1
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City | RIO RANCHO
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State | NM
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Zip | 87124-3761
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Country | US
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Telephone | 505-892-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 10905 FAROLA DR NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-6501
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Country | US
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Telephone | 505-899-5833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DD1864
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License Number State | NM
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