| Encino Dental Care, Inc. | |
|
717 Encino Place Ne Suite 7 Albuquerque NM 87102 | |
| (505) 843-9636 | |
| (505) 843-6277 |
| Full Name | Encino Dental Care, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 717 Encino Place Ne Suite 7, Albuquerque, New Mexico |
| Authorized Official Name and Position | Phillip D Richardson (OWNER / PRESIDENT) |
| Authorized Official Contact | 5058439636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Encino Dental Care, Inc. 717 Encino Place Ne Suite 7 Albuquerque NM 87102 Ph: (505) 843-9636 | Encino Dental Care, Inc. 717 Encino Place Ne Suite 7 Albuquerque NM 87102 Ph: (505) 843-9636 |
| NPI Number | 1225058761 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225058761 | NPI | - | NPPES |
| 38759501 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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