| Advanced Endodontics | |
|
7520 Montgomery Blvd Ne Bldg E1 Albuquerque NM 87109 | |
| (505) 797-1212 | |
| (505) 823-1831 |
| Full Name | Advanced Endodontics |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, New Mexico |
| Authorized Official Name and Position | Shane T Clark (DOCTOR/OWNER) |
| Authorized Official Contact | 5057971212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Endodontics 7520 Montgomery Blvd Ne Bldg E1 Albuquerque NM 87109-1554 Ph: (505) 797-1212 | Advanced Endodontics 7520 Montgomery Blvd Ne Bldg E1 Albuquerque NM 87109 Ph: (505) 797-1212 |
| NPI Number | 1922586262 |
|---|---|
| Provider Enumeration Date | 07/30/2018 |
| Last Update Date | 07/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922586262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | DD4100 (New Mexico) | Primary |
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