Organization
EDGEWOOD FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN L HARRINGTON D.D.S. (OWNER)
(505) 281-0373
Entity
Organization
Contact information
Practice address
1917 OLD HIGHWAY 66, EDGEWOOD, NM 87015-0000
(505) 281-0373
(505) 281-0373
Mailing address
PO BOX 2560, EDGEWOOD, NM 87015-2560
(505) 281-0373
(505) 281-0373
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NM1580
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM1580
STEVE'S NM LISC #
NM
01
—
NM1625
SUE'S NM LISC #
NM
Enumeration date
01/23/2006
Last updated
08/22/2020
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