Organization
ANGEL FIRE DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY DOOLIN DMD (PRESIDENT)
(575) 214-4369
Entity
Organization
Contact information
Practice address
27479 HWY 64, ANGEL FIRE, NM 87710
(575) 214-4369
Mailing address
PO BOX 1953, TAOS, NM 87571-1953
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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