OrganizationActive
6588 East Main Farmington LLC
NPI 1154934818 · General Practice Dentistry · Farmington, NM
Provider details
- NPI number
- 1154934818
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Pam Draper, Office Manager(505) 326-6800
Specialties & taxonomies
Dental Providers
Practice location
6588 E Main St
Farmington, NM 87402-5122
Phone: (505) 326-6800
Fax: (505) 326-6820
Approximate (ZIP-level) locationGet directions
Mailing address
6588 E Main St
Farmington, NM 87402-5122
Other names (DBA / former)
- Doing business as
- Sundance Dental of Country Club
Registry dates
- Enumerated
- 2020-08-24
- Last updated
- 2020-08-24
- Certified
- 2020-08-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.