Provider Demographics
NPI:1255655841
Name:FOLLMER, DAVID PAULE (DDS, LMSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PAULE
Last Name:FOLLMER
Suffix:
Gender:M
Credentials:DDS, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 69 BOX 30
Mailing Address - Street 2:
Mailing Address - City:ROCIADA
Mailing Address - State:NM
Mailing Address - Zip Code:87742-9702
Mailing Address - Country:US
Mailing Address - Phone:505-425-8929
Mailing Address - Fax:
Practice Address - Street 1:HC 69 BOX 30
Practice Address - Street 2:
Practice Address - City:ROCIADA
Practice Address - State:NM
Practice Address - Zip Code:87742-9702
Practice Address - Country:US
Practice Address - Phone:505-425-8929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-071991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical