# SANTA FE ORAL SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sante Fe Oral Surgery LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508287541
- **Authorized official:** MRS. REBECCA J MARTINEZ DDS/MD (PRACTICE MANAGER)
- **Authorized official phone:** (505) 984-0694

## Contact information

- **Practice address:** 2100 CALLE DELA VUEILA STE B103, B103, SANTA FE, NM 87505-4749
- **Practice address phone:** (505) 984-0694
- **Practice address fax:** (505) 983-3270
- **Mailing address:** 2100 CALLE DELA VUEILA STE B103, B103, SANTA FE, NM 87505-4749
- **Mailing address phone:** (505) 984-0694
- **Mailing address fax:** (505) 983-3270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DD3886 | NM | Yes |

## Other

- **Enumeration date:** 12/17/2013
- **Last updated:** 12/26/2019