Southern New Mexico Orthodontics LLC

NPI #1285091181 in Deming, New Mexico

Provider Information

NPI Number: 1285091181
Entity Type: Organization
Organization Name: Southern New Mexico Orthodontics LLC
Primary Specialty: Dentist
Enumeration Date: Jan 22, 2016
Last Updated: Jan 22, 2016

Practice Location

Address: 1310 E PINE ST STE B
City: Deming
State: New Mexico
ZIP Code: 88030-7003
Phone: (575) 544-9999

Authorized Official

Name: EBONIE MARIE BOGDAN
Title: CREDENTIALING SPECIALIST
Phone: (505) 892-9010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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