| Childrens Dental Clinic Of Ruidoso Pc | |
|
721 Mechem Sierra Mall #5 Ruidoso NM 88345-6911 | |
| (505) 257-0246 | |
| (505) 257-0249 |
| Full Name | Childrens Dental Clinic Of Ruidoso Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 721 Mechem Sierra Mall #5, Ruidoso, New Mexico |
| Authorized Official Name and Position | Mack Allen Mcguinness (PRESIDENT) |
| Authorized Official Contact | 5052570246 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Dental Clinic Of Ruidoso Pc 721 Mechem Sierra Mall #5 Ruidoso NM 88345-6911 Ph: (505) 257-0246 | Childrens Dental Clinic Of Ruidoso Pc 721 Mechem Sierra Mall #5 Ruidoso NM 88345-6911 Ph: (505) 257-0246 |
| NPI Number | 1376618967 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 09/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376618967 | NPI | - | NPPES |
| 008C53 | Other | NM | BC/BS OF NM |
| 71823 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DD1984 (New Mexico) | Primary |
Kendal Trujillo Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 456 Mechem Dr Ste C, Ruidoso, NM 88345 Phone: 575-257-5179 | |
Lu Tran Dds Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Sudderth Dr Ste C, Ruidoso, NM 88345 Phone: 575-315-2996 | |
Mountain View Dental Ruidoso Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 127 El Paso Rd, Ruidoso, NM 88345 Phone: 575-257-9053 Fax: 575-258-1194 | |
Mountain View Dental Ruidoso Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 127 El Paso Rd, Ruidoso, NM 88345 Phone: 575-257-9053 Fax: 575-258-1194 | |
Kenneth W Childress Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 721 Mechem Dr, Sierra Mall #5, Ruidoso, NM 88345 Phone: 575-257-0246 |