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General NPI Number Information
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NPI Number | 1942833199
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Entity Type | Organization
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Legal Business Name | SALUD DENTAL GROUP ALBUQUERQUE
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 3803 ATRISCO DR NW STE D
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-4958
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Country | US
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Telephone | 505-833-1550
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Fax | 505-831-8726
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Provider Business Mailing Address
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Address Line | 3803 ATRISCO DR NW STE D
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-4958
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Country | US
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Telephone | 505-833-1550
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Fax | 505-831-8726
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Authorized Official
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Title or Position | FRONT ADMIN
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Name | MARCIA I CHAVEZ
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Credential |
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Telephone | 505-833-1550
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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 |
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License Number State |
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