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Organization
DEMING DENTAL SERVICES, P.A.
Active
Organization
DEMING DENTAL SERVICES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J. O'CONNELL D.D.S. (PRES. CORP.)
(505) 546-2684
Entity
Organization
Contact information
Practice address
400 S GOLD AVE, DEMING, NM 88030-4159
(505) 546-2684
(505) 546-1106
Mailing address
400 S GOLD AVE, DEMING, NM 88030-4159
(505) 546-2684
(505) 546-1106
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1072
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008656
BLUE CROSS & BLUE SHIELD
NM
01
—
3145509
BLUE CROSS OF TENNESSEE
TN
01
—
4908
DORAL DENTAL
NM
01
—
839147
UNITED CONCORDIA
NM
05
—
86546
—
NM
Enumeration date
10/27/2005
Last updated
08/22/2020
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