Provider Demographics
NPI:1932653458
Name:DENTAL PARTNER'S OF RIO RANCHO, LLC
Entity Type:Organization
Organization Name:DENTAL PARTNER'S OF RIO RANCHO, LLC
Other - Org Name:COMFORT DENTAL OF RIO RANCHO, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-400-3739
Mailing Address - Street 1:2003 SOUTHERN BLVD SE
Mailing Address - Street 2:SUITE 133 & 134
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87124-3751
Mailing Address - Country:US
Mailing Address - Phone:505-221-5740
Mailing Address - Fax:
Practice Address - Street 1:2003 SOUTHERN BLVD SE
Practice Address - Street 2:SUITE 133 & 134
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87124-3751
Practice Address - Country:US
Practice Address - Phone:505-221-5740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty