Outreach Dental, LLC

NPI #1982033700 in Gallup, New Mexico

Provider Information

NPI Number: 1982033700
Entity Type: Organization
Organization Name: Outreach Dental, LLC
Primary Specialty: Dentist
Enumeration Date: Nov 2, 2013
Last Updated: Nov 2, 2013

Practice Location

Address: 1700 HELENA DR
City: Gallup
State: New Mexico
ZIP Code: 87301-5610
Phone: (505) 863-7887

Authorized Official

Name: DR. STEPHEN SCOT GRAHAM, D.D.S.
Title: OWNER
Phone: (505) 863-7887

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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