NPI 1356634703

Familia Dental Esp LLC

Organisation Dental Clinic/Center Espanola, NM

Practice location

Address: 1508 N Riverside Dr, Espanola, NM 87532-2054
Phone: (888) 988-4066
Fax: (847) 496-7603
Mailing address: 2050 E Algonquin Rd Suite 610, Schaumburg, IL 60173-4166

Authorised official

Name: Brandon Alexander Taylor
Title: Credentailing & Payer Relations Mgr
Phone: (847) 453-7396

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X

Other Clinic/Center providers in New Mexico →

Registry record

NPI: 1356634703
Entity type: Organization
NPI issued: 18 May 2011
Record last updated: 15 Oct 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.