Individual
DR. TIMOTHY L GUTIERREZ SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1513 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110
(505) 881-7373
(505) 881-5096
Mailing address
1513 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110
(505) 881-7373
(505) 881-5096
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1556
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88906
—
NM
Enumeration date
10/17/2006
Last updated
07/08/2007
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