| Tasker Hatch Rowan Llc | |
|
106 Main St Ne Los Lunas NM 87031-7559 | |
| (505) 865-1999 | |
| (505) 899-4804 |
| Full Name | Tasker Hatch Rowan Llc |
|---|---|
| Speciality | Dentist |
| Location | 106 Main St Ne, Los Lunas, New Mexico |
| Authorized Official Name and Position | Ebonie Gonzales (CREDENTIALING MANAGER) |
| Authorized Official Contact | 5058503769 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tasker Hatch Rowan Llc 8201 Golf Course Rd Nw Ste C3 Albuquerque NM 87120-5805 Ph: (505) 892-9010 | Tasker Hatch Rowan Llc 106 Main St Ne Los Lunas NM 87031-7559 Ph: (505) 865-1999 |
| NPI Number | 1093071987 |
|---|---|
| Provider Enumeration Date | 04/05/2012 |
| Last Update Date | 05/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093071987 | NPI | - | NPPES |
| 22535268 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD2829 (New Mexico) | Primary |
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