| Las Cruces Family Dental | |
|
1423 Don Roser Dr. Las Cruces NM 88011-4515 | |
| (575) 541-0072 | |
| (575) 541-1908 |
| Full Name | Las Cruces Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1423 Don Roser Dr., Las Cruces, New Mexico |
| Authorized Official Name and Position | Eileen Ambriz (PRACTICE MANAGER) |
| Authorized Official Contact | 5755410072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Las Cruces Family Dental 1423 S Don Roser Dr Las Cruces NM 88011-4515 Ph: (575) 541-0072 | Las Cruces Family Dental 1423 Don Roser Dr. Las Cruces NM 88011-4515 Ph: (575) 541-0072 |
| NPI Number | 1366690216 |
|---|---|
| Provider Enumeration Date | 09/04/2008 |
| Last Update Date | 04/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366690216 | NPI | - | NPPES |
| 21223025 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DD2601 (New Mexico) | Primary |
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