| Mark N. Waters, D.d.s, P.C. | |
|
116 W 21st St Clovis NM 88101-4364 | |
| (575) 763-7632 | |
| (575) 762-4226 |
| Full Name | Mark N. Waters, D.d.s, P.C. |
|---|---|
| Speciality | Dentist |
| Location | 116 W 21st St, Clovis, New Mexico |
| Authorized Official Name and Position | Mark Newton Waters (PRESIDENT/DENTIST) |
| Authorized Official Contact | 5757637632 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark N. Waters, D.d.s, P.C. 116 W 21st St Clovis NM 88101-4364 Ph: (575) 763-7632 | Mark N. Waters, D.d.s, P.C. 116 W 21st St Clovis NM 88101-4364 Ph: (575) 763-7632 |
| NPI Number | 1023472313 |
|---|---|
| Provider Enumeration Date | 04/12/2016 |
| Last Update Date | 04/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023472313 | NPI | - | NPPES |
| 794219 | Other | PA | UNITED CORCORDIA |
| 69880832 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD1426 (New Mexico) | Primary |
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Eastern New Mexico Endodontics, PC Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 W 21st St, Suite L1, Clovis, NM 88101 Phone: 575-762-8000 Fax: 575-763-0418 |
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Farnsworth Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 E 21st St, Suite B, Clovis, NM 88101 Phone: 575-762-4794 |
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