Organization
MAUPIN DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET RICHARDSON (OFFICE MANAGER)
(575) 627-0141
Entity
Organization
Contact information
Practice address
114 E 4TH ST STE 100, ROSWELL, NM 88201-6283
(575) 627-0141
(575) 625-6713
Mailing address
114 E 4TH ST STE 100, ROSWELL, NM 88201-6283
(575) 627-0141
(575) 625-6713
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2615
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13687735
—
NM
Enumeration date
06/06/2011
Last updated
06/06/2011
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