Bretmgreenddspc
LBN: Bretmgreenddspc
Bretmgreenddspc is an health care organization with primary practice located at 8501 Candelaria Rd Ne Suite A2, Albuquerque NM 87112-1034. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Dentist is the primary health care specialty.
Bretmgreenddspc can be contacted via phone (505) 299-9606, or through Green, Bret Michael via phone (505) 299-9606.
Contact Information
Primary practice address
8501 Candelaria Rd Ne Suite A2
Albuquerque NM 87112-1034
Phone: (505) 299-9606
Fax:
Website:
Authorized official contact:
Name: Green, Bret Michael Doctor of Dental Surgery (DDS)
Phone: (505) 299-9606
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DD2141 | New Mexico |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | DD2322 | New Mexico |
Profile Details
| NPI number | 1770732208 |
|---|---|
| LBN Legal business name | Bretmgreenddspc |
| DBA Doing business as | |
| Authorized official | Green, Bret Michael Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 9th, 2008 |
| Last updated | Sep 9th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770732208 | NPPES |
| New Mexico | MEDICAID | 9177740 | |
| New Mexico | MEDICAID | 92935001 |
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