Healthcare Provider Details

I. General information

NPI: 1407960958
Provider Name (Legal Business Name): JAMES GOLDEN DURFEY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 S MAIN AVE
AZTEC NM
87410-2247
US

IV. Provider business mailing address

503 S MAIN AVE
AZTEC NM
87410-2247
US

V. Phone/Fax

Practice location:
  • Phone: 505-390-1117
  • Fax: 505-334-9454
Mailing address:
  • Phone: 505-444-0311
  • Fax: 505-334-9454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD2752
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: