# DESOTO DENTISTRY, LLC

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

## Provider details

- **NPI number:** 1417828880
- **Authorized official:** DR. BROCK JAMES DESOTO DDS (DENTIST)
- **Authorized official phone:** (505) 269-1818

## Contact information

- **Practice address:** 5925 WYOMING BLVD NE STE A, ALBUQUERQUE, NM 87109-3841
- **Practice address phone:** (505) 269-1818
- **Mailing address:** 5925 WYOMING BLVD NE STE A, ALBUQUERQUE, NM 87109-3841
- **Mailing address phone:** (505) 269-1818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2025
- **Last updated:** 09/23/2025