Eastern New Mexico Endodontics, PC
NPI #1093261455 in Clovis, New Mexico
Provider Information
- NPI Number
- 1093261455
- Entity Type
- Organization
- Organization Name
- Eastern New Mexico Endodontics, PC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Aug 26, 2016
- Last Updated
- Aug 26, 2016
Practice Location
- Address
- 2000 W 21ST ST
- Address 2
- SUITE L1
- City
- Clovis
- State
- New Mexico
- ZIP Code
- 88101-4087
- Phone
- (575) 762-8000
Authorized Official
- Name
- MR. CHAD RICKY SOUTHARD, FACHE, FHFMA
- Title
- ADMINISTRATOR
- Phone
- (806) 797-4455
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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