# PROFESSIONAL DENTAL CARE OF NEW MEXICO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Devine Dental of Las Vegas, Divine Dental of Santa Fe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477151173
- **Authorized official:** CARY LACOUTURE DDS (OWNER)
- **Authorized official phone:** (303) 521-5701

## Contact information

- **Practice address:** 10233 S PARKER RD STE 107, PARKER, CO 80134-9314
- **Practice address phone:** (303) 887-8848
- **Mailing address:** 10233 S PARKER RD STE 107, PARKER, CO 80134-9314
- **Mailing address phone:** (303) 887-8848

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/14/2020
- **Last updated:** 10/14/2020