Kenneth W Childress DDS PC
NPI #1982913935 in Ruidoso, New Mexico
Provider Information
- NPI Number
- 1982913935
- Entity Type
- Organization
- Organization Name
- Kenneth W Childress DDS PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 24, 2010
- Last Updated
- Mar 14, 2012
Practice Location
- Address
- 721 MECHEM DR
- Address 2
- SIERRA MALL #5
- City
- Ruidoso
- State
- New Mexico
- ZIP Code
- 88345-6911
- Phone
- (575) 257-0246
Authorized Official
- Name
- KENNETH CHILDRESS, DDS
- Title
- PRESIDENT
- Phone
- (719) 671-7369
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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