| Sundance Dental Care Of Gallup | |
|
1601 S Second St Gallup NM 87301-5816 | |
| (505) 722-4422 | |
| (505) 722-2060 |
| Full Name | Sundance Dental Care Of Gallup |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1601 S Second St, Gallup, New Mexico |
| Authorized Official Name and Position | Bruce B Shaheen (DENTIST/OWNER) |
| Authorized Official Contact | 5057224422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sundance Dental Care Of Gallup 1601 S Second St Gallup NM 87301-5816 Ph: (505) 722-4422 | Sundance Dental Care Of Gallup 1601 S Second St Gallup NM 87301-5816 Ph: (505) 722-4422 |
| NPI Number | 1235406927 |
|---|---|
| Provider Enumeration Date | 11/23/2011 |
| Last Update Date | 12/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235406927 | NPI | - | NPPES |
| 97524239 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DD3503 (New Mexico) | Primary |
Tasker Hatch Rowan Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 802 Us Highway 491, Gallup, NM 87301 Phone: 505-892-9010 | |
Valdas Childrens Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 W Green St, Gallup, NM 87301 Phone: 505-870-6128 | |
Gallup Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1421 Us 491, Gallup, NM 87301 Phone: 505-863-8000 | |
1601 2nd Street Gallup Professional, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 S Second St, Gallup, NM 87301 Phone: 505-722-4422 Fax: 505-722-2060 | |
Bradley Vergien Dds, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1421 Us 491, Gallup, NM 87301 Phone: 505-863-8000 | |
Hollywood Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1213c Us Highway 491, Gallup, NM 87301 Phone: 505-979-5600 |