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Organization
SANTA FE COMMUNITY COLLEGE DENTAL CLINIC
Active
Organization
SANTA FE COMMUNITY COLLEGE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED OTERO DDS (DENTIST)
(505) 428-1710
Entity
Organization
Contact information
Practice address
6401 S RICHARDS AVE, SANTA FE, NM 87508-4887
(505) 428-1710
(505) 428-1511
Mailing address
6401 S RICHARDS AVE, SANTA FE, NM 87508-4887
(505) 428-1710
(505) 428-1511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68727
—
NM
Enumeration date
02/15/2008
Last updated
02/15/2008
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