is a Dental Clinic in Fort Sumner, New Mexico. This organization is also known as sub part of De Baca Family Practice Clinic. It is located at 678 Avenue C, Fort Sumner, NM and its contact number is 575-355-2417. The authorized person for is Lisa Walraven
who is Ceo of the clinic and their contact number is 575-355-2420. Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
General Practice Dentistry
Clinic Address:
678 Avenue C, Fort Sumner, New Mexico, 88119
Phone:
575-355-2417
Fax:
575-355-2418
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Lisa Walraven
Position:
Ceo
Contact Number:
575-355-2420
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for clinic are as mentioned below.
NPI Number:
1740090729
Parent Organization:
De Baca Family Practice Clinic
NPI Enumeration Date:
10 Jan, 2025
NPI Last Update On:
22 Jan, 2025
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
Federally Qualified Health Center (FQHC)
Primary
General Practice
Secondary
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Po Box 349, Fort Sumner, New Mexico
Zip:
88119-0349
Phone Number:
575-355-2414
Fax Number:
575-355-7894
Patients can reach at 678 Avenue C, Fort Sumner, New Mexico or can call to book an appointment on 575-355-2417. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.