# FARMINGTON ORAL & MAXILLOFACIAL SURGICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801963939
- **Authorized official:** CHERYL J JAMES (OFFICE MANAGER)
- **Authorized official phone:** (505) 598-9085

## Contact information

- **Practice address:** 20 CR 6070, FARMINGTON, NM 87401
- **Practice address phone:** (505) 590-9085
- **Mailing address:** PO BOX 2872, SURGICAL CLINIC INC, KIRTLAND, NM 87417-2872
- **Mailing address phone:** (505) 598-9085
- **Mailing address fax:** (505) 598-1156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | NMDD1931 | NM | Yes |

## Other

- **Enumeration date:** 11/30/2006
- **Last updated:** 08/22/2020