Organization · Type 2 NPI
Embudo Dental Center LLC
Dental Clinic/Center · Embudo, NM
NPI number
1679017453
Active
Practice location
1102 State Highway 68
Embudo, NM 87531-0037
Fax (505) 579-4074
Mailing address
PO Box 37, 1102 State Highway 68
Embudo, NM 87531-0037
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | DD1953 (NM) |
| Dental Clinic/Center | 261QD0000X | DD1074 (NM) |
Dental Clinic/Center: Definition to come...
Another provider at this address
About NPI 1679017453
Embudo Dental Center LLC's National Provider Identifier is 1679017453, issued on Dec 13, 2016. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Embudo, NM. The record was last updated on Dec 13, 2016.