Professional Dental Care Of Southern Colorado I PLLC
Clinic/Center, Dental in Portales, NM. Organization (NPI-2).
NPI number1033701313
StatusActive
Last updated in NPPESFeb 8, 2021
Details
- NPI
- 1033701313
- Entity type
- Organization (NPI-2)
- Legal business name
- Professional Dental Care Of Southern Colorado I PLLC
- Organization subpart
- Yes
- Enumeration date
- Feb 8, 2021
- Certification date
- Feb 8, 2021
- Last updated
- Feb 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Thompson Smiles (Doing Business As)
Practice location
123 W 2nd StPortales, NM 88130-6201
Phone 575-268-0007
Mailing address
10233 S Parker Rd Ste 107Parker, CO 80134-9314
Phone 303-521-5701
Authorized official
Cary Lacouture
Clinical Director
3035215701
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