COTTONWOOD MALL DENTAL PRACTICE LLC NPI 1043487119

NPI Information

NPI: 1043487119
Provider Name: COTTONWOOD MALL DENTAL PRACTICE, LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
10000 COORS BYP NW
# G-218
ALBUQUERQUE, NM
ZIP 87114
Phone: (505) 242-4867
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COTTONWOOD MALL DENTAL PRACTICE, LLC is a dental clinic center in Albuquerque, NM. COTTONWOOD MALL DENTAL PRACTICE, LLC NPI is 1043487119. The provider is registered as an organization entity type.

The provider's business location address is:

10000 COORS BYP NW
# G-218
ALBUQUERQUE, NM
ZIP 87114-040
Phone: (505) 242-4867
Fax: (505) 890-2883

The provider's authorized official is William A. Sapp .
The authorized official title is President and has the following contact phone number (505) 242-4867.

The enumeration date for this NPI number is 5/8/2008 and was last updated on 4/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1440525	OTHER	NEW MEXICO	UNITED CONCORDIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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