Individual
DR. SU MIN MADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
821 LEXINGTON RD, CLOVIS, NM 88101-4466
(575) 762-2355
Mailing address
821 LEXINGTON RD, CLOVIS, NM 88101-4466
(575) 762-2355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DB-2023-0127
NM
Other
Enumeration date
06/20/2023
Last updated
07/12/2023
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