Cdb Rio Bravo Llc | |
1625 Rio Bravo Blvd Sw Albuquerque NM 87105-6057 | |
(505) 850-0305 | |
Not Available |
Full Name | Cdb Rio Bravo Llc |
---|---|
Speciality | Clinic/center - Dental |
Location | 1625 Rio Bravo Blvd Sw, Albuquerque, New Mexico |
Authorized Official Name and Position | Jonah Foutz (DDS) |
Authorized Official Contact | 5058500305 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Cdb Rio Bravo Llc 7120 Calle Alegria Ne Albuquerque NM 87113-1368 Ph: () - | Cdb Rio Bravo Llc 1625 Rio Bravo Blvd Sw Albuquerque NM 87105-6057 Ph: (505) 850-0305 |
NPI Number | 1447500384 |
---|---|
Provider Enumeration Date | 09/19/2012 |
Last Update Date | 09/19/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447500384 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | DD3662 (New Mexico) | Primary |
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