| Gallup Dental Group | |
|
1421 Us 491 Gallup NM 87301 | |
| (505) 863-8000 | |
| Not Available |
| Full Name | Gallup Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 1421 Us 491, Gallup, New Mexico |
| Authorized Official Name and Position | Michael Kory Rowberry (OWNER) |
| Authorized Official Contact | 5058638000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gallup Dental Group 1312 Redrock Dr Gallup NM 87301-5686 Ph: (505) 979-2023 | Gallup Dental Group 1421 Us 491 Gallup NM 87301 Ph: (505) 863-8000 |
| NPI Number | 1235457607 |
|---|---|
| Provider Enumeration Date | 05/11/2010 |
| Last Update Date | 05/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235457607 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD1562 (New Mexico) | Primary |
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