Provider Demographics
NPI:1205288388
Name:OPPEL FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:OPPEL FAMILY DENTISTRY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:OPPEL-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-249-7795
Mailing Address - Street 1:7520 MONTGOMERY BLVD NE BLDG D2
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1533
Mailing Address - Country:US
Mailing Address - Phone:505-293-9559
Mailing Address - Fax:505-293-9568
Practice Address - Street 1:7520 MONTGOMERY BLVD NE BLDG D2
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1533
Practice Address - Country:US
Practice Address - Phone:505-293-9559
Practice Address - Fax:505-293-9568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD4302122300000X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Single Specialty