Portales Dental Arts Center INC

NPI #1740498179 in Portales, New Mexico

Provider Information

NPI Number: 1740498179
Entity Type: Organization
Organization Name: Portales Dental Arts Center INC
Primary Specialty: Dentist
Enumeration Date: May 18, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1521 W 18TH ST
City: Portales
State: New Mexico
ZIP Code: 88130-7018
Phone: (505) 356-8514

Authorized Official

Name: BUCK R WILSON, D.D.S.
Title: PRESIDENT
Phone: (505) 356-8514

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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