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8501 Candelaria Rd Ne Ne Suite D-2 Albuquerque NM 87112-1034 | |
| (505) 299-9606 | |
| (505) 299-9740 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8501 Candelaria Rd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Spencer John Tasker (OWNER/DENTIST) |
| Authorized Official Contact | 5058929010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8501 Candelaria Rd Ne Ne Suite D-2 Albuquerque NM 87112-1034 Ph: (505) 299-9606 | 8501 Candelaria Rd Ne Ne Suite D-2 Albuquerque NM 87112-1034 Ph: (505) 299-9606 |
| NPI Number | 1609176569 |
|---|---|
| Provider Enumeration Date | 10/26/2010 |
| Last Update Date | 10/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609176569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | PT0111434 (New Mexico) | Primary |
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