Dental Studio On 30th Street PC
NPI #1093111270 in Farmington, New Mexico
Provider Information
- NPI Number
- 1093111270
- Entity Type
- Organization
- Organization Name
- Dental Studio On 30th Street PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 14, 2014
- Last Updated
- Nov 14, 2014
Practice Location
- Address
- 2401 E 30TH ST
- City
- Farmington
- State
- New Mexico
- ZIP Code
- 87401-8939
- Phone
- (505) 325-8858
Authorized Official
- Name
- JOSEPH WILSON, DMD, MSD, LLC
- Title
- OWNER
- Phone
- (505) 360-9592
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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