Provider Demographics
NPI:1699385211
Name:GABALDON-THRONAS, DENISE (DN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:GABALDON-THRONAS
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 954
Mailing Address - Street 2:
Mailing Address - City:OHKAY OWINGEH
Mailing Address - State:NM
Mailing Address - Zip Code:87566-0954
Mailing Address - Country:US
Mailing Address - Phone:505-929-3606
Mailing Address - Fax:
Practice Address - Street 1:2006 BOTULPH RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5730
Practice Address - Country:US
Practice Address - Phone:505-424-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM01040172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath