Organization
FULL SMILE EASTERN FAMILY DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN AMES HODGES (CREDENTIALING SPECIALIST)
(806) 353-1055
Entity
Organization
Contact information
Practice address
1521 W 18TH ST, PORTALES, NM 88130-7018
(806) 353-1055
Mailing address
2201 CIVIC CIR STE 600, AMARILLO, TX 79109-1817
(806) 353-1055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
12/04/2025
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