| Children's Dental Clinic Of Las Cruces | |
|
1901 Calle De Ninos Las Cruces NM 88005-3293 | |
| (575) 526-5522 | |
| (575) 523-5312 |
| Full Name | Children's Dental Clinic Of Las Cruces |
|---|---|
| Speciality | Dentist |
| Location | 1901 Calle De Ninos, Las Cruces, New Mexico |
| Authorized Official Name and Position | Ebonie Gonzales (CREDENTIALING MANAGER) |
| Authorized Official Contact | 5058503769 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Clinic Of Las Cruces 325 S Higley Rd #130 Gilbert AZ 85296 Ph: (505) 850-3769 | Children's Dental Clinic Of Las Cruces 1901 Calle De Ninos Las Cruces NM 88005-3293 Ph: (575) 526-5522 |
| NPI Number | 1134535149 |
|---|---|
| Provider Enumeration Date | 07/10/2014 |
| Last Update Date | 05/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134535149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD3168 (* (Not Available)) | Primary |
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