Organization
ANIMAS PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENS WILSON DMD (PEDIATRIC DENTIST)
(435) 459-4457
Entity
Organization
Contact information
Practice address
2650 E PINON FRONTAGE RD BLDG 200, FARMINGTON, NM 87402-5084
(505) 599-9359
Mailing address
2650 E PINON FRONTAGE RD BLDG 200, FARMINGTON, NM 87402-5084
(505) 599-9359
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
06/13/2023
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