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3501 NORTH BUTLER AVENUE FARMINGTON PROFESSIONAL LLC NPI 1285252627


NPI Information

NPI: 1285252627
Provider Name: 3501 NORTH BUTLER AVENUE FARMINGTON PROFESSIONAL LLC

Doing Business As: FOUR CORNERS FAMILY DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
3501 N BUTLER AVE STE 104
FARMINGTON, NM
ZIP 87401
Phone: (505) 564-4470
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3501 NORTH BUTLER AVENUE FARMINGTON PROFESSIONAL LLC is a general practice dentist in Farmington, NM. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. 3501 NORTH BUTLER AVENUE FARMINGTON PROFESSIONAL LLC NPI is 1285252627. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Four Corners Family Dental.

The provider's business location address is:

3501 N BUTLER AVE STE 104
FARMINGTON, NM
ZIP 87401-430
Phone: (505) 564-4470
Fax: (505) 325-9707

The provider's authorized official is Peter Grumbos .
The authorized official title is Practice Owner and has the following contact phone number (505) 564-4470.

The enumeration date for this NPI number is 7/13/2020 and was last updated on 7/13/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.