| Dr A L Mulliken | |
|
906 W Alameda St Roswell NM 88203-3804 | |
| (505) 622-4383 | |
| (505) 622-4404 |
| Full Name | Dr A L Mulliken |
|---|---|
| Speciality | Dentist |
| Location | 906 W Alameda St, Roswell, New Mexico |
| Authorized Official Name and Position | Albert Laurance Mulliken (OWNER) |
| Authorized Official Contact | 5056224383 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr A L Mulliken 906 W Alameda St Roswell NM 88203-3804 Ph: (505) 622-4383 | Dr A L Mulliken 906 W Alameda St Roswell NM 88203-3804 Ph: (505) 622-4383 |
| NPI Number | 1548345002 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548345002 | NPI | - | NPPES |
| 85928 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 703 (New Mexico) | Primary |
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