| Prakash Dentistry, Llc | |
|
3111 Eubank Blvd Ne Ste B Albuquerque NM 87111-4875 | |
| (505) 296-5458 | |
| Not Available |
| Full Name | Prakash Dentistry, Llc |
|---|---|
| Speciality | Dentist |
| Location | 3111 Eubank Blvd Ne Ste B, Albuquerque, New Mexico |
| Authorized Official Name and Position | Nagashree Prakash (DR.) |
| Authorized Official Contact | 4085822611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prakash Dentistry, Llc 2136 Las Brisas Cir Se Rio Rancho NM 87124-8952 Ph: (408) 582-2611 | Prakash Dentistry, Llc 3111 Eubank Blvd Ne Ste B Albuquerque NM 87111-4875 Ph: (505) 296-5458 |
| NPI Number | 1407370018 |
|---|---|
| Provider Enumeration Date | 07/26/2017 |
| Last Update Date | 07/26/2017 |
| Medicare PECOS PAC ID | 3476810821 |
|---|---|
| Medicare Enrollment ID | O20171120003322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407370018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD3275 (New Mexico) | Primary |
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