Individual
PAUL FERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
780 S WALNUT ST, BLDG 2, LAS CRUCES, NM 88001-1425
(505) 526-2273
Mailing address
780 S WALNUT ST, BLDG 2, LAS CRUCES, NM 88001-1425
(505) 526-2273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2597
NM
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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