Individual
MICHAEL DARAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3 COUNTY ROAD 6523, KIRTLAND, NM 87417-9452
(505) 598-6800
Mailing address
4101 VISTA PINON DR, FARMINGTON, NM 87401-8619
(801) 318-8615
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD4137
NM
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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