Organization
K. JARED LUSK DDS P.C.
Active
Other names
Lusk Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. K. JARED LUSK (PRESIDENT)
(505) 325-8401
Entity
Organization
Contact information
Practice address
204 N AUBURN AVE, FARMINGTON, NM 87401-8412
(505) 325-8401
(505) 325-8705
Mailing address
204 N AUBURN AVE, FARMINGTON, NM 87401-8412
(505) 325-8401
(505) 325-8705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
891069
UNITED CONCORDIA
NM
01
—
NM008392
BLUECROSS BLUESHIELD
NM
Enumeration date
04/26/2007
Last updated
08/22/2020
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