| Four Corners Family Dental | |
|
3501 N Butler Ave Ste 104 Farmington NM 87401-6430 | |
| (505) 564-4470 | |
| (505) 325-9707 |
| Full Name | Four Corners Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3501 N Butler Ave Ste 104, Farmington, New Mexico |
| Authorized Official Name and Position | Peter Grumbos (PRACTICE OWNER) |
| Authorized Official Contact | 5055644470 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Corners Family Dental 3501 N Butler Ave Ste 104 Farmington NM 87401-6430 Ph: (505) 564-4470 | Four Corners Family Dental 3501 N Butler Ave Ste 104 Farmington NM 87401-6430 Ph: (505) 564-4470 |
| NPI Number | 1285252627 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 07/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285252627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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