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General NPI Number Information
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NPI Number | 1730865692
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Entity Type | Individual
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Provider Name | ELLA ALGERMISSEN DDS
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 1904 WELLSPRING AVE SE #101
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City | RIO RANCHO
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State | NM
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Zip | 87124
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Country | US
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Telephone | 505-896-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 400 SHIRK LANE SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87105
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Country | US
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Telephone |
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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 | DB-2023-0153
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License Number State | NM
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