| Grace Children's Dentistry | |
|
6400 Holly Ave Ne Ste M Albuquerque NM 87113 | |
| (512) 787-7174 | |
| Not Available |
| Full Name | Grace Children's Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6400 Holly Ave Ne Ste M, Albuquerque, New Mexico |
| Authorized Official Name and Position | Scott Siegel (OWNER) |
| Authorized Official Contact | 5127877174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Children's Dentistry 4319 Nambe Ct Las Cruces NM 88011-4290 Ph: (512) 787-7174 | Grace Children's Dentistry 6400 Holly Ave Ne Ste M Albuquerque NM 87113 Ph: (512) 787-7174 |
| NPI Number | 1376047795 |
|---|---|
| Provider Enumeration Date | 03/20/2018 |
| Last Update Date | 06/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376047795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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