| Albuquerque West Smiles Youth Dentistry, Pc | |
|
111 Coors Blvd Nw E-6 Albuquerque NM 87121-2006 | |
| (505) 352-3808 | |
| (505) 352-3811 |
| Full Name | Albuquerque West Smiles Youth Dentistry, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 111 Coors Blvd Nw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Kim Freeman (REGIONAL MANAGER) |
| Authorized Official Contact | 5053779911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Albuquerque West Smiles Youth Dentistry, Pc 111 Coors Blvd Nw Ste E6 Albuquerque NM 87121-2009 Ph: (505) 352-3808 | Albuquerque West Smiles Youth Dentistry, Pc 111 Coors Blvd Nw E-6 Albuquerque NM 87121-2006 Ph: (505) 352-3808 |
| NPI Number | 1730137217 |
|---|---|
| Provider Enumeration Date | 05/05/2006 |
| Last Update Date | 09/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730137217 | NPI | - | NPPES |
| 77532 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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