| Sb Dental Llc | |
|
219 Courthouse Rd Se Los Lunas NM 87031-6811 | |
| (505) 865-4341 | |
| Not Available |
| Full Name | Sb Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 219 Courthouse Rd Se, Los Lunas, New Mexico |
| Authorized Official Name and Position | Jajung Yoon (CEP) |
| Authorized Official Contact | 7183097310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sb Dental Llc 219 Courthouse Rd Se Los Lunas NM 87031-6811 Ph: (505) 865-4341 | Sb Dental Llc 219 Courthouse Rd Se Los Lunas NM 87031-6811 Ph: (505) 865-4341 |
| NPI Number | 1376055574 |
|---|---|
| Provider Enumeration Date | 10/27/2017 |
| Last Update Date | 10/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376055574 | NPI | - | NPPES |
| 80133321 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DD4403 (New Mexico) | Primary |
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