Organization
SOCORRO DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE HANNA (OWNER)
(575) 993-5032
Entity
Organization
Contact information
Practice address
204B NEEL AVE, SOCORRO, NM 87801-4649
(267) 318-6667
Mailing address
204B NEEL AVE, SOCORRO, NM 87801-4649
(575) 993-5032
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD4651
NM
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881755825
NPI
NM
05
—
89223829
—
NM
Enumeration date
12/07/2016
Last updated
08/30/2022
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