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General NPI Number Information
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NPI Number | 1851899751
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Entity Type | Organization
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Legal Business Name | NEW MEXICO COMMUNITY DENTAL
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2116 HINKLE ST SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-4930
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Country | US
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Telephone | 505-843-7493
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Fax |
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Provider Business Mailing Address
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Address Line | 2116 HINKLE ST SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-4930
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Country | US
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Telephone | 505-843-7493
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. KWEI TSCHEN
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Credential |
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Telephone | 216-904-2805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State | NM
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