Jeffrey J Supple DMD

NPI 1073609020 - Dentist - 1223G0001X

NPI Details
NPI 1073609020
Gender Male
Enumeration Date 10/05/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
6800 MONTGOMERY BLVD NE
SUITE G
ALBUQUERQUE NM, 87109-1405, US
Phone (505) 883-3933
Fax (505) 883-3934
Business Location
6800 MONTGOMERY BLVD NE
SUITE G
ALBUQUERQUE NM, 87109-1405, US
Phone (505) 883-3933
Fax (505) 883-3934
Toxanomy
Taxonomy Code 1223G0001X
License State New Mexico
License Number DD1731
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According to our database, Dr. Jeffrey J Supple DMD NPI is 1073609020, taxonomy code is 1223G0001X and license number is DD1731, license state is located at New Mexico. Jeffrey J Supple DMD physically located at 6800 Montgomery Blvd Ne, Albuquerque NM, 87109-1405. NPI Number Jeffrey J Supple DMD has the Individual type.

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1073609020 NPI number is provided on an as is basis without warranty of any kind. 1073609020 is maintained by the National Plan & Provider Enumeration System. The contents of Jeffrey J Supple DMD are for informational purposes only.