San Juan Oral & Facial Surgery
NPI #1104228329 in Farmington, New Mexico
Provider Information
- NPI Number
- 1104228329
- Entity Type
- Organization
- Organization Name
- San Juan Oral & Facial Surgery
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Sep 18, 2014
- Last Updated
- Mar 3, 2021
Practice Location
- Address
- 2990 E PINON FRONTAGE RD STE 102
- City
- Farmington
- State
- New Mexico
- ZIP Code
- 87402-5068
- Phone
- (505) 333-8635
Authorized Official
- Name
- BEVERLY K BRADFORD, DDS
- Title
- OFFICE MANAGER
- Phone
- (505) 333-8635
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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