Chama Valley Dental Care

NPI #1386918399 in Chama, New Mexico

Provider Information

NPI Number: 1386918399
Entity Type: Organization
Organization Name: Chama Valley Dental Care
Primary Specialty: Dentist
Enumeration Date: Mar 8, 2012
Last Updated: Mar 8, 2012

Practice Location

Address: 451 MAPLE AVE.
City: Chama
State: New Mexico
ZIP Code: 87520
Phone: (575) 756-2901

Authorized Official

Name: GRANT ALLEN
Title: DENTIST
Phone: (575) 756-2901

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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