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Organization

PLAINS DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JULIE A O'QUINN D.D.S. (OWNER)
(575) 742-3100
Entity
Organization

Contact information

Practice address
121 W LLANO ESTACADO BLVD, CLOVIS, NM 88101
(575) 742-3100
(575) 742-3400
Mailing address
121 W LLANO ESTACADO BLVD, CLOVIS, NM 88101
(575) 742-3100
(575) 742-3400

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD1887
NM
122300000X
Dentist
DD3395
NM
124Q00000X
Dental Hygienist
DH1504
NM
124Q00000X
Dental Hygienist
DH2245
NM
124Q00000X
Dental Hygienist
DH2884
NM
126800000X
Dental Assistant
DA2349
NM
126800000X
Dental Assistant
DA3975
NM

Other

Enumeration date
01/18/2011
Last updated
12/23/2019
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