Individual
LIILIA VAN MAANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 FARMINGTON AVE STE 1, FARMINGTON, NM 87401-4559
(505) 325-9133
Mailing address
1309 E 27TH ST, FARMINGTON, NM 87401-9007
(505) 258-2899
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH4120
NM
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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