BRIAN POTOCKI

ROSWELL, NM
NPI1194098723
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: NM  DD4166)
Additional Taxonomies122300000X Dentist
(Licence: MI  2901020710)
Enumeration Date2012-02-13
Last Update Date2014-09-05
Business Address
-- BRIAN POTOCKI
3751 N MAIN ST SUITE D
ROSWELL, NM 88201-0300
Phone number: 517-281-4747
Mailing Address
-- BRIAN POTOCKI
530 N TELSHOR BLVD SUITE B
LAS CRUCES, NM 88011-8243
Phone number: