| Pueblo De Cochiti | |
|
255 Cochiti St Cochiti Pueblo NM 87072-9998 | |
| (505) 465-2244 | |
| (505) 465-1135 |
| Full Name | Pueblo De Cochiti |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 255 Cochiti St, Cochiti Pueblo, New Mexico |
| Authorized Official Name and Position | Philip Quintana (GOVERNOR) |
| Authorized Official Contact | 5054652244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pueblo De Cochiti 255 Cochiti St Cochiti Pueblo NM 87072-9998 Ph: (505) 465-2244 | Pueblo De Cochiti 255 Cochiti St Cochiti Pueblo NM 87072-9998 Ph: (505) 465-2244 |
| NPI Number | 1184855504 |
|---|---|
| Provider Enumeration Date | 08/03/2009 |
| Last Update Date | 07/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184855504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 343900000X | Non-emergency Medical Transport (van) | (New Mexico) | Secondary |