A to Z Children'S Dental Clinic, LLC
Organization Active NPI Dental Clinic/Center · Grants, NM
NPI 1275738668 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1275738668
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- License
- DD1966 (NM)
- Legal business name
- A TO Z CHILDREN'S DENTAL CLINIC, LLC
- Practice address
- 805 E High St
Grants, NM 87020-2448 - Phone
- (505) 876-1065
- NPI assigned
- Jun 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Marcellus Gladney, D.M.D.
- Title
- President
- Phone
- (505) 876-1065
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | DD1966 | NM | Yes |
Addresses
Primary practice location
805 E High St
Grants, NM 87020-2448
Mailing address
805 E High St
PO Box 638
Grants, NM 87020-2448
Phone (505) 876-1065
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z9089 | Medicaid | NM | |
| 8615 | Medicaid | NM |
Other providers in Grants, NM
- 4 Corners HHC
- 920 Lobo Canyon Grants Professional, LLC
- Martha Abeyta
- Ken Abraham
- Adobe Foot and Ankle Specialists, P.C.
- Martha Alcocer
- Alexandra Aldaz
All providers in Grants, NM · Dental Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.