Santa Fe Community College Dental Clinic
Dentist, General Practice in Santa Fe, NM. Organization (NPI-2).
NPI number1790953404
StatusActive
Last updated in NPPESFeb 15, 2008
Details
- NPI
- 1790953404
- Entity type
- Organization (NPI-2)
- Legal business name
- Santa Fe Community College Dental Clinic
- Organization subpart
- No
- Enumeration date
- Feb 15, 2008
- Last updated
- Feb 15, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
6401 S Richards AveSanta Fe, NM 87508-4887
Phone 505-428-1710 · Fax 505-428-1511
Mailing address
6401 S Richards AveSanta Fe, NM 87508-4887
Phone 505-428-1710 · Fax 505-428-1511
Authorized official
Alfred Otero
Dentist
5054281710
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