Organization
SUNDANCE ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HODGES (OPERATIONS DIRECTOR)
(505) 787-2965
Entity
Organization
Contact information
Practice address
3903 BECKLAND DR, FARMINGTON, NM 87402-4701
(505) 436-2727
(505) 326-6800
Mailing address
6588 E MAIN ST, FARMINGTON, NM 87402-5122
(505) 326-6800
(505) 326-6800
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD2287
NM
Other
Enumeration date
08/06/2014
Last updated
10/15/2020
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