Full Smile Eastern Family Dentistry, Pllc | |
1521 W 18th St Portales NM 88130-7018 | |
(806) 353-1055 | |
Not Available |
Full Name | Full Smile Eastern Family Dentistry, Pllc |
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Speciality | Clinic/center - Dental |
Location | 1521 W 18th St, Portales, New Mexico |
Authorized Official Name and Position | Lauren Ames Hodges (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 8063531055 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Full Smile Eastern Family Dentistry, Pllc 2201 Civic Cir Ste 600 Amarillo TX 79109-1817 Ph: (806) 353-1055 | Full Smile Eastern Family Dentistry, Pllc 1521 W 18th St Portales NM 88130-7018 Ph: (806) 353-1055 |
NPI Number | 1114753837 |
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Provider Enumeration Date | 09/10/2024 |
Last Update Date | 09/10/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114753837 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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