Organization
ESMAEL VALDEZ, D.D.S., P.C
Active
Other names
Divine Dental Centre
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESMAEL ROBERT VALDEZ D.D.S. (OWNER)
(505) 454-8483
Entity
Organization
Contact information
Practice address
925 MILLS AVE, LAS VEGAS, NM 87701-4047
(505) 454-8483
Mailing address
925 MILLS AVE, LAS VEGAS, NM 87701-4047
(505) 454-8483
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD2351
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44456310
—
NM
Enumeration date
03/20/2007
Last updated
08/22/2020
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