| El Centro Family Health Espanola Dental Clinic | |
|
608 La Joya St Ste B Espanola NM 87532-3467 | |
| (505) 753-9454 | |
| (505) 753-0850 |
| Full Name | El Centro Family Health Espanola Dental Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 608 La Joya St Ste B, Espanola, New Mexico |
| Authorized Official Name and Position | Lore Pease (CEO) |
| Authorized Official Contact | 5057537218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| El Centro Family Health Espanola Dental Clinic 538 N Paseo De Onate P.o. Box 158 Espanola NM 87532-2618 Ph: (505) 753-7218 | El Centro Family Health Espanola Dental Clinic 608 La Joya St Ste B Espanola NM 87532-3467 Ph: (505) 753-9454 |
| NPI Number | 1952661282 |
|---|---|
| Provider Enumeration Date | 05/21/2012 |
| Last Update Date | 06/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952661282 | NPI | - | NPPES |
| 1780689034 | Other | NM | ORGANIZATION NPPES |
| 47953063 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Familia Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1508 N Riverside Dr, Espanola, NM 87532 Phone: 888-988-4066 Fax: 847-496-7603 | |
Michael S. Redman, D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 704 La Joya St, Espanola, NM 87532 Phone: 505-753-2230 Fax: 505-753-7163 | |
Tess Simmons Dds, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 704 La Joya St Ste A, Espanola, NM 87532 Phone: 505-753-2230 | |
Robert J Manzanares Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 232 Paseo De Onate, Espanola, NM 87532 Phone: 505-753-7246 Fax: 505-753-4359 |