Organization
PEDIATRIC DENTAL SPECIALIST OF NEW MEXICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER ANDREW HAYES DMD, MS. (PEDIATRIC DENTAL SPECIALIST)
(575) 621-0800
Entity
Organization
Contact information
Practice address
2450 SOUTH TELSHOR, MEMORIAL MEDICAL HOSPITAL, LAS CRUCES, NM 88011-7594
(575) 621-0800
(575) 373-3091
Mailing address
5475 REMINGTON ROAD, DR. PETER HAYES, LAS CRUCES, NM 88011-7594
(575) 621-0800
(575) 373-3091
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2233
NM
122300000X
Dentist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92472214
—
NM
Enumeration date
12/08/2010
Last updated
12/08/2010
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