Full Smile Eastern Family Dentistry, Pllc
NPI #1114753837 in Portales, New Mexico
Provider Information
- NPI Number
- 1114753837
- Entity Type
- Organization
- Organization Name
- Full Smile Eastern Family Dentistry, Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 10, 2024
- Last Updated
- Dec 4, 2025
Practice Location
- Address
- 1521 W 18TH ST
- City
- Portales
- State
- New Mexico
- ZIP Code
- 88130-7018
- Phone
- (806) 353-1055
Authorized Official
- Name
- LAUREN AMES HODGES
- Title
- CREDENTIALING SPECIALIST
- Phone
- (806) 353-1055
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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