Professional Dental Care of Northern New Mexico II
NPI #1982293189 in Taos, New Mexico
Provider Information
- NPI Number
- 1982293189
- Entity Type
- Organization
- Organization Name
- Professional Dental Care of Northern New Mexico II
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SSUN HEALTH, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 12, 2021
- Last Updated
- Jan 12, 2021
Practice Location
- Address
- 1337 GUSDORF RD STE A
- City
- Taos
- State
- New Mexico
- ZIP Code
- 87571-6296
- Phone
- (505) 751-9661
Authorized Official
- Name
- CARY LACOUTURE, DDS
- Title
- CLINICAL MANAGER
- Phone
- (303) 521-5701
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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