Jared Michael Southwell DMD

NPI 1689950503 - Dentist - 122300000X

NPI Details
NPI 1689950503
Gender Male
Enumeration Date 10/24/2011
Last Updated 08/10/2012
Entity Type Individual
Active Over 5 years ago
Practice Location
3 ROAD 6523
KIRTLAND NM, 87417-9452, US
Phone (505) 598-6800
Fax (505) 598-6830
Business Location
204 W 38TH ST
FARMINGTON NM, 87401-4036, US
Phone (805) 657-2913
Taxonomy Code 122300000X
License State New Mexico
License Number DD3690
Remove 1689950503 NPI Number

According to our database, Dr. Jared Michael Southwell DMD NPI is 1689950503, taxonomy code is 122300000X and license number is DD3690, license state is located at New Mexico. Jared Michael Southwell DMD physically located at 3 Road 6523, Kirtland NM, 87417-9452. NPI Number Jared Michael Southwell DMD has the Individual type.

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1689950503 NPI number is provided on an as is basis without warranty of any kind. 1689950503 is maintained by the National Plan & Provider Enumeration System. The contents of Jared Michael Southwell DMD are for informational purposes only.