| Cdb Rio Bravo Llc | |
|
1625 Rio Bravo Blvd Sw Albuquerque NM 87105-6057 | |
| (505) 850-0305 | |
| Not Available |
| Full Name | Cdb Rio Bravo Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1625 Rio Bravo Blvd Sw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jonah Foutz (DDS) |
| Authorized Official Contact | 5058500305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cdb Rio Bravo Llc 7120 Calle Alegria Ne Albuquerque NM 87113-1368 Ph: () - | Cdb Rio Bravo Llc 1625 Rio Bravo Blvd Sw Albuquerque NM 87105-6057 Ph: (505) 850-0305 |
| NPI Number | 1447500384 |
|---|---|
| Provider Enumeration Date | 09/19/2012 |
| Last Update Date | 09/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447500384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DD3662 (New Mexico) | Primary |
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