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Organization
SMILEMAKER DENTAL INC.
Active
Organization
SMILEMAKER DENTAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS D. PARKS D.D.S. (PRESIDENT)
(505) 334-6116
Entity
Organization
Contact information
Practice address
501 S MAIN AVE, AZTEC, NM 87410-2247
(505) 334-6116
Mailing address
501 S MAIN AVE, AZTEC, NM 87410-2247
(505) 334-6116
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD 1903
NM
Other
Enumeration date
07/11/2006
Last updated
08/22/2020
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