Provider Demographics
NPI:1053867168
Name:DENTAL PARTNERS OF EAST PASEO DEL NORTE LLC
Entity Type:Organization
Organization Name:DENTAL PARTNERS OF EAST PASEO DEL NORTE LLC
Other - Org Name:COMFORT DENTAL OF EAST PASEO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-510-9954
Mailing Address - Street 1:7900 SAN PEDRO DR NE
Mailing Address - Street 2:SUITE C-5
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4672
Mailing Address - Country:US
Mailing Address - Phone:801-510-9954
Mailing Address - Fax:
Practice Address - Street 1:7900 SAN PEDRO DR NE
Practice Address - Street 2:SUITE C-5
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4672
Practice Address - Country:US
Practice Address - Phone:801-510-9954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty