IndividualActive
Gerald Prohaska, DDS,MS
NPI 1821179508 · Orthodontics and Dentofacial Orthopedics Dentistry · Albuquerque, NM
Provider details
- NPI number
- 1821179508
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DDS,MS
- Sex
- Male
- Sole proprietor
- No
- License
- 826 (NM)
Practice location
6800 Montgomery Blvd Ne
Suite B
Albuquerque, NM 87109-1405
Phone: (505) 881-1100
Fax: (505) 884-2933
Mailing address
6800 Montgomery Blvd Ne
Albuquerque, NM 87109-1405
Registry dates
- Enumerated
- 2006-10-18
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.