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Individual

MRS. CHRISTIE ANN BACA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
925 MILLS AVE, LAS VEGAS, NM 87701-4047
(505) 454-8483
(505) 454-8767
Mailing address
925 MILLS AVE, LAS VEGAS, NM 87701-4047
(505) 454-8483
(505) 454-8767

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH1103
NM

Other

Enumeration date
12/22/2006
Last updated
07/08/2007
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