Just Clean Smiles, Llc | |
1204 Main St Ne Suite B Los Lunas NM 87031-7409 | |
(505) 565-0609 | |
(505) 565-0709 |
Full Name | Just Clean Smiles, Llc |
---|---|
Speciality | Dental Hygienist |
Location | 1204 Main St Ne, Los Lunas, New Mexico |
Authorized Official Name and Position | Donna M Riordan (MANAGER/DENTAL HYGIENIST) |
Authorized Official Contact | 5055650609 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Just Clean Smiles, Llc 1204 Main St Ne Suite B Los Lunas NM 87031-7409 Ph: (505) 565-0609 | Just Clean Smiles, Llc 1204 Main St Ne Suite B Los Lunas NM 87031-7409 Ph: (505) 565-0609 |
NPI Number | 1609176965 |
---|---|
Provider Enumeration Date | 11/02/2010 |
Last Update Date | 03/27/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609176965 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 1503 (New Mexico) | Secondary |
124Q00000X | Dental Hygienist | DH-373 (New Mexico) | Primary |
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