Organization
DR DAVID J HERMAN'S FOUR CORNERS DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELCEY RIGHTMIRE (ADMINSTRATIVE ASSISTANT)
(505) 564-9000
Entity
Organization
Contact information
Practice address
3751 N BUTLER AVE, SUITE 113, FARMINGTON, NM 87401-6425
(505) 564-9000
(505) 564-9100
Mailing address
3751 N BUTLER AVE, SUITE 113, FARMINGTON, NM 87401-6425
(505) 564-9000
(505) 564-9100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2459
NM
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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