Organization
AGAVE DENTAL BRIGHT STAR PLLC
Active
Other names
Bright Star Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAKE WILLIAMS DDS (MEMBER)
(385) 335-0928
Entity
Organization
Contact information
Practice address
2010 E LOHMAN AVE STE A, LAS CRUCES, NM 88001-3109
(575) 526-4334
(575) 526-7863
Mailing address
2010 E LOHMAN AVE STE A, LAS CRUCES, NM 88001-3109
(575) 526-4334
(575) 526-7863
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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