Organization
FOUR CORNERS ORTHODONTICS CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HERMAN D.D.S., M.S., M.P.H. (ORHTODONTIST)
(505) 564-9000
Entity
Organization
Contact information
Practice address
3751 N BUTLER AVE, SUITE 113, FARMINGTON, NM 87401-6435
(505) 564-9000
(505) 564-9100
Mailing address
3751 N BUTLER AVE, SUITE 113, FARMINGTON, NM 87401-6435
(505) 564-9000
(505) 564-9100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DD1859
NM
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD1859
NM
Other
Enumeration date
01/18/2007
Last updated
10/24/2013
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