Sb Dental Llc | |
219 Courthouse Rd Se Los Lunas NM 87031-6811 | |
(505) 865-4341 | |
Not Available |
Full Name | Sb Dental Llc |
---|---|
Speciality | Clinic/center - Dental |
Location | 219 Courthouse Rd Se, Los Lunas, New Mexico |
Authorized Official Name and Position | Jajung Yoon (CEP) |
Authorized Official Contact | 7183097310 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sb Dental Llc 219 Courthouse Rd Se Los Lunas NM 87031-6811 Ph: (505) 865-4341 | Sb Dental Llc 219 Courthouse Rd Se Los Lunas NM 87031-6811 Ph: (505) 865-4341 |
NPI Number | 1376055574 |
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Provider Enumeration Date | 10/27/2017 |
Last Update Date | 10/27/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376055574 | NPI | - | NPPES |
80133321 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | DD4403 (New Mexico) | Primary |
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