Organization
NEW MEXICO DENTAL INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE HANNA (OWNER)
(575) 993-5032
Entity
Organization
Contact information
Practice address
204B NEEL AVE, SOCORRO, NM 87801-4649
(575) 993-5032
(505) 226-9697
Mailing address
204B NEEL AVE, SOCORRO, NM 87801-4649
(575) 993-5032
(505) 226-9697
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89223829
—
NM
Enumeration date
12/16/2021
Last updated
12/16/2021
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