| Doniphan Family Dental | |
|
6821 Doniphan Dr Canutillo TX 79835 | |
| (915) 788-4949 | |
| (915) 877-4242 |
| Full Name | Doniphan Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6821 Doniphan Dr, Canutillo, Texas |
| Authorized Official Name and Position | Chetan Shivaram (OWNER/PRESIDENT) |
| Authorized Official Contact | 9158774949 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Doniphan Family Dental 6821 Doniphan Drive Canutillo TX 79835 Ph: (915) 788-4949 | Doniphan Family Dental 6821 Doniphan Dr Canutillo TX 79835 Ph: (915) 788-4949 |
| NPI Number | 1932353257 |
|---|---|
| Provider Enumeration Date | 11/13/2008 |
| Last Update Date | 11/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932353257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21666 (Texas) | Primary |
Jim Lam Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6821 Doniphan Dr, Canutillo, TX 79835 Phone: 915-877-4949 Fax: 915-877-4242 |