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General NPI Number Information
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NPI Number | 1780195024
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Entity Type | Organization
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Legal Business Name | DEVIN GIRON, DDS
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 10/13/2017
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Provider Practice Location Address
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Address Line | 2 CALLE MEDICO STE 3
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City | SANTA FE
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State | NM
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Zip | 87505-4785
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Country | US
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Telephone | 505-992-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 2740 TRAMWAY CIR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-1205
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Country | US
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Telephone | 505-715-8405
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DEVIN KYLE GIRON
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Credential | DDS
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Telephone | 505-715-8405
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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 | DD3314
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License Number State | NM
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