Individual
JOHN DEFLICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1691 GALISTEO ST, SUITE C, SANTA FE, NM 87505-4780
(505) 983-5631
(505) 983-5605
Mailing address
1691 GALISTEO ST, SUITE C, SANTA FE, NM 87505-4780
(505) 983-5631
(505) 983-5605
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
83-22
NM
Other
Enumeration date
08/05/2006
Last updated
03/17/2008
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