Individual
DR. CAMILA IBAGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3700 N PRINCE ST, CLOVIS, NM 88101-2103
(575) 219-3040
Mailing address
3700 N PRINCE ST, CLOVIS, NM 88101-2103
(575) 219-3040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD5468
NM
Other
Enumeration date
07/09/2021
Last updated
07/22/2021
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