| Angel Fire Dental Corp | |
|
27479 Hwy 64 Angel Fire NM 87710 | |
| (575) 214-4369 | |
| Not Available |
| Full Name | Angel Fire Dental Corp |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 27479 Hwy 64, Angel Fire, New Mexico |
| Authorized Official Name and Position | Timothy Doolin (PRESIDENT) |
| Authorized Official Contact | 5752144369 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Fire Dental Corp Po Box 1953 Taos NM 87571-1953 Ph: () - | Angel Fire Dental Corp 27479 Hwy 64 Angel Fire NM 87710 Ph: (575) 214-4369 |
| NPI Number | 1346802188 |
|---|---|
| Provider Enumeration Date | 07/02/2019 |
| Last Update Date | 07/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346802188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Angel Fire Family Dentistry Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 27479 Hwy 64, Angel Fire, NM 87710 Phone: 575-377-1383 Fax: 575-377-1383 |