| Socorro Dental Llc | |
|
204b Neel Ave Socorro NM 87801-4649 | |
| (267) 318-6667 | |
| Not Available |
| Full Name | Socorro Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 204b Neel Ave, Socorro, New Mexico |
| Authorized Official Name and Position | George Hanna (OWNER) |
| Authorized Official Contact | 5759935032 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Socorro Dental Llc 204b Neel Ave Socorro NM 87801-4649 Ph: (575) 993-5032 | Socorro Dental Llc 204b Neel Ave Socorro NM 87801-4649 Ph: (267) 318-6667 |
| NPI Number | 1932643038 |
|---|---|
| Provider Enumeration Date | 12/07/2016 |
| Last Update Date | 08/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932643038 | NPI | - | NPPES |
| 89223829 | Medicaid | NM | |
| 1881755825 | Other | NM | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD4651 (New Mexico) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Dr Marian T Lucero Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 824 Highway 60, Socorro, NM 87801 Phone: 505-835-2342 Fax: 505-835-2207 | |
New Mexico Dental Institute Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 204b Neel Ave, Socorro, NM 87801 Phone: 575-993-5032 Fax: 505-226-9697 |