Individual
DR. VISANIO ELARRYO MUKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1700 CERRILLOS RD, SANTA FE, NM 87505-3026
(505) 946-9485
Mailing address
1700 CERRILLOS RD, SANTA FE, NM 87505-3026
(505) 946-9485
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401413408
VA
122300000X
Dentist
Primary
15189
MD
Other
Enumeration date
01/04/2012
Last updated
10/16/2015
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