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Organization
EDUCARE DENTAL SERVICES, INC.
Active
Organization
EDUCARE DENTAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA ANN LAKIN RDH (OWNER)
(505) 762-4833
Entity
Organization
Contact information
Practice address
7 PINEWAY BLVD, CLOVIS, NM 88101-8464
(505) 762-4833
(505) 762-4833
Mailing address
7 PINEWAY BLVD, CLOVIS, NM 88101-8464
(505) 762-4833
(505) 762-4833
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
464
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16900588
PROVIDER I.D.
NM
05
—
68528
—
NM
Enumeration date
10/27/2005
Last updated
03/11/2010
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