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Organization
BECKLAND DENTAL KIDS OF FARMINGTON LLC
Active
Organization
BECKLAND DENTAL KIDS OF FARMINGTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HODGES (OPERATIONS DIRECTOR)
(505) 787-2965
Entity
Organization
Contact information
Practice address
3903 BECKLAND DR, FARMINGTON, NM 87402-4701
(505) 436-2735
(505) 436-2735
Mailing address
3909 BECKLAND DR., FARMINGTON, NM 87402
(505) 436-2735
(505) 436-2736
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DD2872
NM
1223G0001X
General Practice Dentistry
Primary
DD3385
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99183064
—
NM
Enumeration date
10/18/2016
Last updated
10/15/2020
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