| Dental Studio On 30th Street Pc | |
|
2401 E 30th St Farmington NM 87401-8939 | |
| (505) 325-8858 | |
| Not Available |
| Full Name | Dental Studio On 30th Street Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2401 E 30th St, Farmington, New Mexico |
| Authorized Official Name and Position | Joseph Wilson (OWNER) |
| Authorized Official Contact | 5053609592 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Studio On 30th Street Pc 2401 E 30th St Farmington NM 87401-8939 Ph: (505) 325-8858 | Dental Studio On 30th Street Pc 2401 E 30th St Farmington NM 87401-8939 Ph: (505) 325-8858 |
| NPI Number | 1093111270 |
|---|---|
| Provider Enumeration Date | 11/14/2014 |
| Last Update Date | 11/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093111270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DD3399 (New Mexico) | Primary |
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