Provider Demographics
NPI:1568854339
Name:PAPWORTH ENDODONTICS
Entity Type:Organization
Organization Name:PAPWORTH ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:PAPWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-294-3636
Mailing Address - Street 1:10151 MONTGOMERY BLVD NE
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3670
Mailing Address - Country:US
Mailing Address - Phone:505-294-3636
Mailing Address - Fax:
Practice Address - Street 1:10151 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE 1-C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3670
Practice Address - Country:US
Practice Address - Phone:505-294-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty