Organization
PROFESSIONAL DENTAL CARE OF SOUTHERN NM I PLLC
Active
Parent organization
PROFESSIONAL DENTAL CARE PLLC
Other names
Peter Thompson, DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROFESSIONAL DENTAL CARE PLLC
Authorized official
CARY LACOUTURE DDS (CLINICAL DIRECTOR)
(303) 521-5701
Entity
Organization
Contact information
Practice address
123 W 2ND ST, PORTALES, NM 88130-6201
(575) 448-8863
Mailing address
123 W 2ND ST, PORTALES, NM 88130-6201
(575) 448-8863
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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