San Miguel Dental

NPI #1033400601 in Las Vegas, New Mexico

Provider Information

NPI Number
1033400601
Entity Type
Organization
Organization Name
San Miguel Dental
Primary Specialty
Dentist - General Practice
Enumeration Date
Apr 29, 2011
Last Updated
Apr 29, 2011

Practice Location

Address
2503 RIDGE RUNNER RD
ZIP Code
87701-4972
Phone
(505) 425-6434

Authorized Official

Name
DR. WILFRED B PACHECO, DDS
Title
OWNER
Phone
(505) 425-6434

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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