Provider Demographics
NPI:1073286043
Name:BEST, MARISSA JOY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:JOY
Last Name:BEST
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 FAIRWAY TERRACE N
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101
Mailing Address - Country:US
Mailing Address - Phone:575-762-3711
Mailing Address - Fax:575-762-4142
Practice Address - Street 1:221 FAIRWAY TERRACE N
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101
Practice Address - Country:US
Practice Address - Phone:575-762-3711
Practice Address - Fax:575-762-4142
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD54721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice