Organization
NATIONAL ORTHODONTIX MANAGEMENT, PLLC
Active
Parent organization
NATIONAL ORTHODONTIX MANAGEMENT, PLLC
Other names
SUN Orthodontix of Las Cruces PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NATIONAL ORTHODONTIX MANAGEMENT, PLLC
Authorized official
DR. JOHN G. VONDRAK DDS (OPERATING MANAGER)
(505) 521-0900
Entity
Organization
Contact information
Practice address
920 N TELSHOR BLVD, SUITE E, LAS CRUCES, NM 88011-8244
(575) 521-0900
(575) 521-0128
Mailing address
920 N TELSHOR BLVD, SUITE E, LAS CRUCES, NM 88011-8244
(575) 521-0900
(575) 521-0128
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD2276
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00785351
—
NM
05
—
105971
—
NM
Enumeration date
05/16/2006
Last updated
12/19/2011
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