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General NPI Number Information
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NPI Number | 1942298047
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Entity Type | Individual
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Provider Name | ALICIA ANN ABEYTA DDS
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 5901 WYOMING BLVD NE STE Q
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3859
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Country | US
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Telephone | 505-585-1342
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Fax |
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Provider Business Mailing Address
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Address Line | 8020 BEVERLY HILLS AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-3606
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Country | US
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Telephone | 505-353-1184
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DD2626
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License Number State | NM
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