Organization
EL PASO DENTAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC GUTIERREZ DDS (OWNER/DENTIST)
(915) 855-8484
Entity
Organization
Contact information
Practice address
11625 PELLICANO DR, EL PASO, TX 79936-6242
(915) 855-8484
Mailing address
11625 PELLICANO DR, EL PASO, TX 79936-6242
(915) 855-8484
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164941514
INDIVIDUAL NPI
TX
Enumeration date
08/19/2021
Last updated
08/19/2021
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