Individual
DR. WIL B PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
546 N 10TH STREET, FORT SUMNER, NM 88119
(575) 355-2414
Mailing address
PO BOX 349, FORT SUMNER, NM 88119-0349
(575) 355-2414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1606
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87312
—
NM
Enumeration date
12/31/2006
Last updated
08/06/2013
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