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120 E Highway 550 Bernalillo NM 87004-5967 | |
| (505) 550-0503 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 120 E Highway 550, Bernalillo, New Mexico |
| Authorized Official Name and Position | Jonah L Foutz (OWNER) |
| Authorized Official Contact | 5055500305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
120 E Highway 550 Bernalillo NM 87004-5967 Ph: () - | 120 E Highway 550 Bernalillo NM 87004-5967 Ph: (505) 550-0503 |
| NPI Number | 1174992564 |
|---|---|
| Provider Enumeration Date | 09/16/2015 |
| Last Update Date | 09/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174992564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DD3662 (New Mexico) | Primary |
Celebraces 550 Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 E Hwy 550, Bernalillo, NM 87004 Phone: 720-427-2818 | |
Perfect Teeth / Venada Plaza P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Nm 528, Suite I, Bernalillo, NM 87004 Phone: 505-867-0665 |