Clovis Hospital Dentistry PC
Organization Active NPI General Practice Dentistry · Clovis, NM
NPI 1083968077 · NPPES record last updated Oct 30, 2012
Key facts
- NPI
- 1083968077
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DD3553 (NM)
- Legal business name
- CLOVIS HOSPITAL DENTISTRY PC
- Practice address
- 2100 N Martin Luther King Jr. Blvd
Clovis, NM 88101 - Phone
- (575) 763-9382
- NPI assigned
- Oct 30, 2012
- Organization subpart
- No
Authorized official
- Name
- Falon Waisath, D.M.D.
- Title
- President
- Phone
- (575) 763-9382
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | DD3553 | NM | Yes |
Addresses
Primary practice location
2100 N Martin Luther King Jr. Blvd
Clovis, NM 88101
Mailing address
1552 Bosc CT
Clovis, NM 88101-2334
Phone (575) 763-9382
Other providers in Clovis, NM
- Clovis Family Health Care Center LLC
- Clovis Family Healthcare Center LLC
- Clovis Family Urgent Care LLC
- Clovis Healthcare and Rehabilitation Center, LLC
- Clovis Homecare, Inc.
- Clovis Medical Associates LLC
- Clovis Municipal Schools
- Clovis Municipal Schools
- Clovis Municipal Schools
- Clovis Orthodontics, PLLC
All providers in Clovis, NM · General Practice Dentistry in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.