| Full Name | |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 6 Road 7586, Bloomfield, New Mexico |
| Authorized Official Name and Position | Fannessa Comer (CEO) |
| Authorized Official Contact | 5053686006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 160 Attnbusiness Office Manager Shiprock NM 87420-0160 Ph: (505) 368-6401 | 6 Road 7586 Bloomfield NM 87413 Ph: (505) 368-6401 |
| NPI Number | 1760427587 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 07/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760427587 | NPI | - | NPPES |
| 418188 | Medicaid | AZ | |
| 7000000084 | Medicaid | UT | |
| 7000000092 | Medicaid | UT | |
| 89805 | Medicaid | NM | |
| 95017950 | Medicaid | CO |
Sundance Dental Care Of Bloomfield, Llc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 South First Street, Bloomfield, NM 87413 Phone: 505-632-3344 | |
100 South Bloomfield Professional, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 S 1st St, Bloomfield, NM 87413 Phone: 505-632-3344 |