| Chama Valley Dental Care | |
|
451 Maple Ave. Chama NM 87520 | |
| (575) 756-2901 | |
| Not Available |
| Full Name | Chama Valley Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 451 Maple Ave., Chama, New Mexico |
| Authorized Official Name and Position | Grant Allen (DENTIST) |
| Authorized Official Contact | 5757562901 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chama Valley Dental Care Po Box 276 Chama NM 87520-0276 Ph: () - | Chama Valley Dental Care 451 Maple Ave. Chama NM 87520 Ph: (575) 756-2901 |
| NPI Number | 1386918399 |
|---|---|
| Provider Enumeration Date | 03/08/2012 |
| Last Update Date | 03/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386918399 | NPI | - | NPPES |
| 00085538 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD1550 (New Mexico) | Primary |