| Full Smile Eastern Family Dentistry, Pllc | |
|
1521 W 18th St Portales NM 88130-7018 | |
| (806) 353-1055 | |
| Not Available |
| Full Name | Full Smile Eastern Family Dentistry, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1521 W 18th St, Portales, New Mexico |
| Authorized Official Name and Position | Lauren Ames Hodges (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8063531055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Smile Eastern Family Dentistry, Pllc 2201 Civic Cir Ste 600 Amarillo TX 79109-1817 Ph: (806) 353-1055 | Full Smile Eastern Family Dentistry, Pllc 1521 W 18th St Portales NM 88130-7018 Ph: (806) 353-1055 |
| NPI Number | 1114753837 |
|---|---|
| Provider Enumeration Date | 09/10/2024 |
| Last Update Date | 09/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114753837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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