Individual provider · Type 1 NPI

Michael J. Fanning, DDS, M.S.D.

Orthodontics and Dentofacial Orthopedics Dentistry · Albuquerque, NM

NPI number 1700153475 Active

Practice location

8212 Louisiana Blvd NE Ste A
Albuquerque, NM 87113-2105

Call (505) 400-9855 Map

Mailing address

5507 Eakes Rd NW
Los Ranchos, NM 87107-5529

Specialties and licenses

TaxonomyCodeLicense
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400XDD3356 (NM)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1700153475

Michael J. Fanning, DDS, M.S.D.'s National Provider Identifier is 1700153475, issued on Nov 24, 2011. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Albuquerque, NM. The record was last updated on Nov 24, 2011.