Organization
PUEBLO DE COCHITI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP QUINTANA (GOVERNOR)
(505) 465-2244
Entity
Organization
Contact information
Practice address
255 COCHITI ST, COCHITI PUEBLO, NM 87072-9998
(505) 465-2244
(505) 465-1135
Mailing address
255 COCHITI ST, COCHITI PUEBLO, NM 87072-9998
(505) 465-2244
(505) 465-1135
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
NM
Other
Enumeration date
08/03/2009
Last updated
07/17/2012
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