FOUR CORNERS FAMILY DENTAL LLC

FARMINGTON, NM
NPI1669795456
Entity TypeOrganization
Authorized ContactTYLER ANTHONY MANN
Dentist
505-564-4470
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
Enumeration Date2010-03-08
Last Update Date2010-03-08
Business Address
FOUR CORNERS FAMILY DENTAL LLC
383 CANYONVIEW DR
FARMINGTON, NM 87401-8629
Phone number: 505-564-4470
Mailing Address
FOUR CORNERS FAMILY DENTAL LLC
3501 N BUTLER AVE STE 114
FARMINGTON, NM 87401-6429
Phone number: 505-564-4470