| Portales Dental Arts Center Inc | |
|
1521 W 18th St Portales NM 88130-7018 | |
| (505) 356-8514 | |
| Not Available |
| Full Name | Portales Dental Arts Center Inc |
|---|---|
| Speciality | Dentist |
| Location | 1521 W 18th St, Portales, New Mexico |
| Authorized Official Name and Position | Buck R Wilson (PRESIDENT) |
| Authorized Official Contact | 5053568514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portales Dental Arts Center Inc 1521 W 18th St Portales NM 88130-7018 Ph: (505) 356-8514 | Portales Dental Arts Center Inc 1521 W 18th St Portales NM 88130-7018 Ph: (505) 356-8514 |
| NPI Number | 1740498179 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740498179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD916 (New Mexico) | Primary |
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