Embudo Dental Center LLC
NPI #1679017453 in Embudo, New Mexico
Provider Information
- NPI Number
- 1679017453
- Entity Type
- Organization
- Organization Name
- Embudo Dental Center LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Dec 13, 2016
- Last Updated
- Dec 13, 2016
Practice Location
- Address
- 1102 STATE HIGHWAY 68
- City
- Embudo
- State
- New Mexico
- ZIP Code
- 87531-0037
- Phone
- (505) 579-4680
Authorized Official
- Name
- KELLIE A HARRIS, DDS
- Title
- OWNER/DENTIST
- Phone
- (505) 579-4680
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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