Edgewood Family Dentistry

NPI 1316917495 - Dentist - 1223G0001X

NPI Details
NPI 1316917495
Enumeration Date 01/23/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name STEPHEN L STEPHEN
Position OWNER
Phone (505) 281-0373
Fax (505) 281-0373
Practice Location
1917 OLD HIGHWAY 66
EDGEWOOD NM, 87015-0000, US
Phone (505) 281-0373
Fax (505) 281-0373
Business Location
PO BOX 2560
EDGEWOOD NM, 87015-2560, US
Phone (505) 281-0373
Fax (505) 281-0373
Toxanomy
Taxonomy Code 1223G0001X
License State New Mexico
License Number NM1580
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According to our database, Edgewood Family Dentistry NPI is 1316917495, taxonomy code is 1223G0001X and license number is NM1580, license state is located at New Mexico. Edgewood Family Dentistry physically located at 1917 Old Highway 66, Edgewood NM, 87015-0000. NPI Number 1033115704 has the healthcare provider type.

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1316917495 NPI number is provided on an as is basis without warranty of any kind. 1316917495 is maintained by the National Plan & Provider Enumeration System. The contents of Edgewood Family Dentistry are for informational purposes only.