Provider Demographics
NPI:1558792986
Name:ACC HEALTH
Entity Type:Organization
Organization Name:ACC HEALTH
Other - Org Name:ACC CONSULTANTS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:505-323-1300
Mailing Address - Street 1:901 LAMBERTON PL NE STE W
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1659
Mailing Address - Country:US
Mailing Address - Phone:505-323-1300
Mailing Address - Fax:505-323-1400
Practice Address - Street 1:901 LAMBERTON PL NE STE W
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1659
Practice Address - Country:US
Practice Address - Phone:505-323-1300
Practice Address - Fax:505-323-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD29411223D0001X
261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty