OPEN WIDE DENTISTRY LLC
NPI 1255581393
Clinic/Center - Dental in Albuquerque, NM
Active since September 25, 2008
About Open Wide Dentistry Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OPEN WIDE DENTISTRY LLC (NPI 1255581393) is a healthcare organization registered as a dental in Albuquerque, New Mexico and active in the NPI registry since September 2008. The organization lists Sandra Lee Keanna, Owner, as its authorized official.
NPPES Registry Identity
NPI1255581393
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameOPEN WIDE DENTISTRY LLC
Location Address1100 LEAD AVE SEAlbuquerque, NM 87106
Mailing Address1100 Lead Ave SeAlbuquerque, NM 87106-5215 · (505) 292-8533 · Fax (505) 292-2712
Phone(505) 292-8533
Fax(505) 292-2712
Organization SubpartNo
Authorized OfficialSandra Lee KeannaOwner · (505) 292-8533
Enumeration DateSeptember 25, 2008
✔ NPI 1255581393 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1100 LEAD AVE SE, Albuquerque, NM 87106
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Internal Medicine (Gastroenterology)
1100 LEAD AVE SE
ALBUQUERQUE, NM 87106
ALBUQUERQUE, NM 87106
Internal Medicine (Gastroenterology)
1100 LEAD AVE SE
ALBUQUERQUE, NM 87106
ALBUQUERQUE, NM 87106
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255581393, enumerated as an "organization" on September 25, 2008.
The provider is located at 1100 LEAD AVE SE ALBUQUERQUE, NM 87106 and the phone number is (505) 292-8533.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
