| Michael E Roussel Dmd Pc | |
|
7127 Prospect Pl Ne Albuquerque NM 87110-4313 | |
| (505) 881-4365 | |
| (505) 881-8282 |
| Full Name | Michael E Roussel Dmd Pc |
|---|---|
| Speciality | Dentist |
| Location | 7127 Prospect Pl Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Michael E Roussel (OWNER) |
| Authorized Official Contact | 5058814365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael E Roussel Dmd Pc 7127 Prospect Pl Ne Albuquerque NM 87110-4313 Ph: (505) 881-4365 | Michael E Roussel Dmd Pc 7127 Prospect Pl Ne Albuquerque NM 87110-4313 Ph: (505) 881-4365 |
| NPI Number | 1205215506 |
|---|---|
| Provider Enumeration Date | 05/20/2015 |
| Last Update Date | 06/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205215506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1422 (New Mexico) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 1422 (New Mexico) | Secondary |
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