Individual
DALLIN GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2200 GRANDE BLVD SE STE A, RIO RANCHO, NM 87124-1695
(505) 891-1500
(972) 590-8809
Mailing address
7496 FOOTHILL DR, LAKE POINT, UT 84074-8925
(801) 472-3105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11297718-9922
UT
1223G0001X
General Practice Dentistry
Primary
DD5116
NM
Other
Enumeration date
06/13/2019
Last updated
09/10/2019
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