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Organization
ESMAEL VALDEZ, D.D.S., P.C
Active
Organization
ESMAEL VALDEZ, D.D.S., P.C
Active
Other names
Divine Dental Centre
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESMAEL ROBERT VALDEZ D.D.S. (OWNER)
(505) 454-8483
Entity
Organization
Contact information
Practice address
925 MILLS AVE, LAS VEGAS, NM 87701-4047
(505) 454-8483
Mailing address
925 MILLS AVE, LAS VEGAS, NM 87701-4047
(505) 454-8483
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2351
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44456310
—
NM
Enumeration date
03/20/2007
Last updated
08/22/2020
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