Individual
KRISTI MIYOKO QUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 THORPE RD, LAS CRUCES, NM 88012-9776
(575) 382-9292
(575) 382-2061
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD3802
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2012
Last updated
06/24/2013
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