Gallup Indian Medical Center
NPI #1952505208 in Ft . Wingate, New Mexico
Provider Information
- NPI Number
- 1952505208
- Entity Type
- Organization
- Organization Name
- Gallup Indian Medical Center
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jun 12, 2007
- Last Updated
- Jul 22, 2008
Practice Location
- Address
- 520 B SHUSH DRIVE
- Address 2
- EXIT 33 STATE ROAD 400
- City
- Ft . Wingate
- State
- New Mexico
- ZIP Code
- 87316
- Phone
- (505) 722-1770
Authorized Official
- Name
- BENNIE C. YAZZIE
- Title
- ACTING CEO
- Phone
- (505) 722-1000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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