George D Pollard, DDS
Individual provider Active NPI Dentist · Zuni, NM
NPI 1396919239 · NPPES record last updated Mar 20, 2015
Key facts
- NPI
- 1396919239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5166 (CO)
- Practice address
- Route 301 North 21 B Ave
Zuni, NM 87327-0467 - Phone
- (505) 782-7349
- Fax
- (505) 782-7405
- NPI assigned
- Apr 22, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5166 | CO | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5166 | CO | Yes |
Addresses
Primary practice location
Route 301 North 21 B Ave
Zuni, NM 87327-0467
Mailing address
PO Box 467
Zuni, NM 87327-0467
Phone (505) 782-7349
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 88357775 | Medicaid | NM |
Other providers in Zuni, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2015. 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.