| Familia Dental | |
|
1620 Main St Nw Ste D Los Lunas NM 87031-4891 | |
| (505) 565-0651 | |
| (505) 565-2031 |
| Full Name | Familia Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1620 Main St Nw, Los Lunas, New Mexico |
| Authorized Official Name and Position | Brandon Alexander Taylor (CREDENTIALING & PAYER RELATIONS MAN) |
| Authorized Official Contact | 8474537396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental 2050 East Algonquin Road Suite 610 Schaumburg IL 60173-4166 Ph: (847) 453-7396 | Familia Dental 1620 Main St Nw Ste D Los Lunas NM 87031-4891 Ph: (505) 565-0651 |
| NPI Number | 1417377177 |
|---|---|
| Provider Enumeration Date | 04/21/2014 |
| Last Update Date | 10/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417377177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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