Healthcare Provider Details
I. General information
NPI: 1972360733
Provider Name (Legal Business Name): FARNSWORTH ORTHO HOBBS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/28/2024
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2526 N FOWLER ST
HOBBS NM
88240-1958
US
IV. Provider business mailing address
2526 N FOWLER ST
HOBBS NM
88240-1958
US
V. Phone/Fax
- Phone: 575-392-4509
- Fax:
- Phone: 575-392-4509
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
FARNSWORTH
Title or Position: PRESIDENT/OWNER
Credential: DDS, MS
Phone: 575-392-4509