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Contact Information

CLOVIS HOSPITAL DENTISTRY PC
2100 N MARTIN LUTHER KING JR. BLVD
CLOVIS, NM88101
 Phone: 575-763-9382
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for CLOVIS HOSPITAL DENTISTRY PC

NPI # 1083968077
LBN Legal business name CLOVIS HOSPITAL DENTISTRY PC
Authorized official FALON WAISATH - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/30/2012
Last updated 10/30/2012 - About 14 years ago
Identifiers
NM License # DD3553
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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