Derrick Baca DDS LLC
NPI #1902214406 in Grants, New Mexico
Provider Information
- NPI Number
- 1902214406
- Entity Type
- Organization
- Organization Name
- Derrick Baca DDS LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jul 28, 2014
- Last Updated
- Jul 28, 2014
Practice Location
- Address
- 1209 BONITA ST
- City
- Grants
- State
- New Mexico
- ZIP Code
- 87020-2103
- Phone
- (505) 876-4034
Authorized Official
- Name
- DR. DERRICK R BACA, DDS
- Title
- GENERAL DENTIST
- Phone
- (505) 876-4034
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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