Provider First Line Business Mailing Address:
2201 LOUISIANA BLVD NE STE D
Provider Second Line Business Mailing Address:
UPTOWN PARK DENTAL PRACTICE, LLC
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87110-4547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-883-4867
Provider Business Mailing Address Fax Number:
505-883-4007