NPI 1376792903

Michelle R Tom, DA

Practitioner Dental Assistant Gallup, NM

Practice location

Address: 516 Nizhoni Blvd, Gallup, NM 87301-5748
Phone: (505) 722-1000
Fax: (505) 722-1565
Mailing address: PO Box 1337, Gallup, NM 87305-1337

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X

Other Dental Assistant providers in New Mexico →

Registry record

NPI: 1376792903
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Sep 2008
Record last updated: 18 Sep 2008

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.