| Eastern Family Dentistry, Llc | |
|
1521 W 18th St Portales NM 88130-7018 | |
| (575) 356-8514 | |
| Not Available |
| Full Name | Eastern Family Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1521 W 18th St, Portales, New Mexico |
| Authorized Official Name and Position | Jesse Martin (PARTNER) |
| Authorized Official Contact | 5753568514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Family Dentistry, Llc 1521 W 18th St Portales NM 88130-7018 Ph: (575) 356-8514 | Eastern Family Dentistry, Llc 1521 W 18th St Portales NM 88130-7018 Ph: (575) 356-8514 |
| NPI Number | 1407280530 |
|---|---|
| Provider Enumeration Date | 08/26/2013 |
| Last Update Date | 08/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407280530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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