DHHS PHS IHS ACL LAGUNA DENTAL CLINIC NPI 1558436261

NPI Information

NPI: 1558436261
Provider Name: DHHS PHS IHS ACL LAGUNA DENTAL CLINIC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
STATE RD #124 EXIT 108 OFF I-40 3 MI NORTH
LAGUNA DENTAL CLINIC
NEW LAGUNA, NM
ZIP 87038
Phone: (505) 552-6645
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DHHS PHS IHS ACL LAGUNA DENTAL CLINIC is a dental clinic center in New Laguna, NM. DHHS PHS IHS ACL LAGUNA DENTAL CLINIC NPI is 1558436261. The provider is registered as an organization entity type.

The provider's business location address is:

STATE RD #124 EXIT 108 OFF I-40 3 MI NORTH
LAGUNA DENTAL CLINIC
NEW LAGUNA, NM
ZIP 87038
Phone: (505) 552-6645

The provider's authorized official is William R Thorne .
The authorized official title is Acl Ihs Ceo and has the following contact phone number (505) 552-5301.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 8/22/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H3451	MEDICAID	NEW MEXICO

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: 5/5/2024

NPI Synchronization or Removal

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