Organization
RED RIVER FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PU (VP OF FINANCE)
(972) 869-3789
Entity
Organization
Contact information
Practice address
612 W MAIN STREET, RED RIVER, NM 87558
(575) 754-2300
Mailing address
2403 LACY LN, CARROLLTON, TX 75006-6514
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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