Organization
SONOMA FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY THOMPSON D.M.D. (OWNER)
(575) 522-0454
Entity
Organization
Contact information
Practice address
3015 HILLRISE DR, LAS CRUCES, NM 88011-4703
(575) 522-0454
Mailing address
3340 RINCONADA BLVD, SUITE B, LAS CRUCES, NM 88011
(575) 522-0454
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3462
NM
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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