Individual
DR. MAX WARREN WAHOSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3150 E MAIN ST STE A55, FARMINGTON, NM 87402-7630
(505) 436-3569
Mailing address
4212 SEDONA CT, FARMINGTON, NM 87401-9280
(225) 335-2601
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD5514
NM
1223G0001X
General Practice Dentistry
DD5514
NM
Other
Enumeration date
08/24/2021
Last updated
07/18/2023
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