Clovis Hospital Dentistry PC

NPI #1083968077 in Clovis, New Mexico

Provider Information

NPI Number
1083968077
Entity Type
Organization
Organization Name
Clovis Hospital Dentistry PC
Primary Specialty
Dentist - General Practice
Enumeration Date
Oct 30, 2012
Last Updated
Oct 30, 2012

Practice Location

Address
2100 N MARTIN LUTHER KING JR. BLVD
City
Clovis
ZIP Code
88101
Phone
(575) 763-9382

Authorized Official

Name
FALON WAISATH, D.M.D.
Title
PRESIDENT
Phone
(575) 763-9382

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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