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Contact Information

PUEBLO OF ISLETA
01 SAGEBRUSH RD
ISLETA, NM87022-0000
 Phone: 505-869-4863
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Public Health

1223D0001X
Indicates primary specialty

NPI Profile & details for PUEBLO OF ISLETA · (Female)

NPI Number 1225158348
Status Active
Credentials
Entity Individual
Enumeration date 03/30/2007
Last updated 05/17/2017 - About 9 years ago
Sole proprietor 1 Not specified
Identifiers
  • NM License # 501C
  • NM Medicaid 55528309
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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