# TIMOTHY L GUTIERREZ DMD PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013070911
- **Authorized official:** DR. TIMOTHY LEE GUTIERREZ SR. DMD (ORAL MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (505) 881-7373

## Contact information

- **Practice address:** 1513 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110
- **Practice address phone:** (505) 881-7373
- **Practice address fax:** (505) 881-5096
- **Mailing address:** 1513 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110
- **Mailing address phone:** (505) 881-7373
- **Mailing address fax:** (505) 881-5096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 1556 | NM | Yes |

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 08/22/2020