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Organization
AGAVE DENTAL BRIGHT STAR PLLC
Active
Organization
AGAVE DENTAL BRIGHT STAR PLLC
Active
Other names
Bright Star Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAKE WILLIAMS DDS (MEMBER)
(385) 335-0928
Entity
Organization
Contact information
Practice address
2010 E LOHMAN AVE STE A, LAS CRUCES, NM 88001-3109
(575) 526-4334
(575) 526-7863
Mailing address
2010 E LOHMAN AVE STE A, LAS CRUCES, NM 88001-3109
(575) 526-4334
(575) 526-7863
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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