OrganizationActive
San Juan Oral & Facial Surgery
NPI 1104228329 · Oral and Maxillofacial Surgery (Dentist) · Farmington, NM
Provider details
- NPI number
- 1104228329
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Authorized official
- Beverly Bradford, Office Manager
Practice location
2990 E Pinon Frontage Rd Ste 102
Farmington, NM 87402-5068
Phone: (505) 333-8635
Fax: (505) 258-4909
Mailing address
2990 E Pinon Frontage Rd Ste 102
Farmington, NM 87402-5068
Registry dates
- Enumerated
- 2014-09-18
- Last updated
- 2021-03-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.