Individual
MYRNA L POLICARPIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1960 N DATE ST, T OR C, NM 87901-3701
(575) 894-7662
(575) 894-7930
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2984
NM
Other
Enumeration date
04/30/2008
Last updated
08/24/2020
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