Provider Demographics
NPI:1588784722
Name:HORACE E. ROSS, D.D.S.,P.C.
Entity type:Organization
Organization Name:HORACE E. ROSS, D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HORACE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-392-5501
Mailing Address - Street 1:3208 N GRIMES ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-1253
Mailing Address - Country:US
Mailing Address - Phone:505-392-5501
Mailing Address - Fax:505-392-1534
Practice Address - Street 1:3208 N GRIMES ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-1253
Practice Address - Country:US
Practice Address - Phone:505-392-5501
Practice Address - Fax:505-392-1534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM883261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental