Eastern Family Dentistry, LLC
NPI #1407280530 in Portales, New Mexico
Provider Information
- NPI Number
- 1407280530
- Entity Type
- Organization
- Organization Name
- Eastern Family Dentistry, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 26, 2013
- Last Updated
- Aug 26, 2013
Practice Location
- Address
- 1521 W 18TH ST
- City
- Portales
- State
- New Mexico
- ZIP Code
- 88130-7018
- Phone
- (575) 356-8514
Authorized Official
- Name
- JESSE MARTIN
- Title
- PARTNER
- Phone
- (575) 356-8514
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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