Organization · Type 2 NPI

Professional Dental Care of Southern NM I PLLC

General Practice Dentistry · Portales, NM

NPI number 1306415955 Active

Practice location

123 W 2nd St
Portales, NM 88130-6201

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2 other providers at this address

Other general practice dentistry providers in Portales

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NPI record

NPI: 1306415955
Entity type: Organization (Type 2)
Issued: Jun 18, 2021
Last updated: Jun 18, 2021
Status: Active
Subpart: Yes of Professional Dental Care PLLC

Other names

<unavail>
Peter Thompson, DDS · doing business as

Authorized official

Cary Lacouture, DDS
Clinical Director
(303) 521-5701

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1306415955

Professional Dental Care of Southern NM I PLLC's National Provider Identifier is 1306415955, issued on Jun 18, 2021. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Portales, NM. The record was last updated on Jun 18, 2021.