Organization
SIERRA BLANCA FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK J DIMOTTA MD (PROVIDER OWNER)
(575) 630-1214
Entity
Organization
Contact information
Practice address
208 PORR DR, RUIDOSO, NM 88345-6713
(575) 630-1214
(575) 630-2083
Mailing address
208 PORR DR, RUIDOSO, NM 88345-6713
(575) 630-1214
(575) 630-2083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000-25
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72884
—
NM
Enumeration date
09/27/2013
Last updated
09/27/2013
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