| Dental Innovations Of Gallup | |
|
214 W Aztec Ave Gallup NM 87301-6302 | |
| (505) 863-4457 | |
| (505) 722-4310 |
| Full Name | Dental Innovations Of Gallup |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 214 W Aztec Ave, Gallup, New Mexico |
| Authorized Official Name and Position | Richard Paul Baker (OWNER) |
| Authorized Official Contact | 5058634457 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Innovations Of Gallup 214 W Aztec Ave Gallup NM 87301-6302 Ph: (505) 863-4457 | Dental Innovations Of Gallup 214 W Aztec Ave Gallup NM 87301-6302 Ph: (505) 863-4457 |
| NPI Number | 1528315074 |
|---|---|
| Provider Enumeration Date | 08/14/2012 |
| Last Update Date | 08/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528315074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | TD0029 (New Mexico) | Primary |
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