Individual
REYNALDO MOYCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4250 CERRILLOS RD STE 1202, BOX 29476, SANTA FE, NM 87592-2000
(505) 982-4867
(505) 424-8535
Mailing address
PO BOX 29476, 4250 CERRILLOS RD #1202, SANTA FE, NM 87592-9476
(505) 982-4867
(505) 424-8535
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27905
CA
122300000X
Dentist
Primary
DD3823
NM
Other
Enumeration date
10/05/2006
Last updated
03/07/2014
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