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General NPI Number Information
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NPI Number | 1922799816
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Entity Type | Organization
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Legal Business Name | SUCCESS SMILES ORTHODONTICS SOUTH VALLEY
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 6660 CENTRAL AVE SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87121-2029
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Country | US
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Telephone | 505-569-6639
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Fax |
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Provider Business Mailing Address
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Address Line | 8216 LOUISIANA BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2105
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Country | US
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Telephone | 505-569-6639
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST/OWNER
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Name | DR. LIGIA PADILLA
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Credential | DDS
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Telephone | 505-569-6639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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