Professional Dental Care Pllc

NPI #1285264242 in Santa Fe, New Mexico

Provider Information

NPI Number
1285264242
Entity Type
Organization
Organization Name
Professional Dental Care Pllc
Primary Specialty
Dentist - General Practice
Enumeration Date
Jan 18, 2020
Last Updated
Jan 18, 2020

Practice Location

Address
550 SAINT MICHAELS DR STE 2
ZIP Code
87505-7604
Phone
(505) 216-2364

Authorized Official

Name
DR. FRED ANTHONY LACOURT, DDS
Title
CHIEF DENTAL OFFICER
Phone
(414) 303-7484

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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