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717 Encino Pl Ne Ste 6 Albuquerque NM 87102-2624 | |
| (505) 247-8005 | |
| (505) 843-8589 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 717 Encino Pl Ne Ste 6, Albuquerque, New Mexico |
| Authorized Official Name and Position | Kapil Grewal (MANAGING DENTIST) |
| Authorized Official Contact | 4154907704 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
717 Encino Pl Ne Ste 6 Albuquerque NM 87102-2624 Ph: (505) 247-8005 | 717 Encino Pl Ne Ste 6 Albuquerque NM 87102-2624 Ph: (505) 247-8005 |
| NPI Number | 1831554989 |
|---|---|
| Provider Enumeration Date | 12/16/2015 |
| Last Update Date | 04/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831554989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DD4182 (New Mexico) | Primary |
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