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General NPI Number Information
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NPI Number | 1962896332
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Entity Type | Organization
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Legal Business Name | DDS LLC
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 6747 ACADEMY RD NE SUITE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3384
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Country | US
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Telephone | 505-822-5100
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Fax | 505-822-5106
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Provider Business Mailing Address
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Address Line | 6747 ACADEMY RD NE SUITE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3384
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Country | US
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Telephone | 505-822-5100
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Fax | 505-822-5106
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Authorized Official
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Title or Position | MEMBER
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Name | BELINDA C MELTON
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Credential |
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Telephone | 505-822-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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