Individual
MRS. JUANITA E. LINTECUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
111 N RAILROAD AVE, ESPANOLA, NM 87532-2627
(505) 753-7218
(505) 753-5815
Mailing address
STATE ROAD 75 #15136, P.O. BX 516, PENASCO, NM 87553-0516
(575) 587-2809
(575) 587-2605
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH2333
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
321831
PENASCO DENTAL
NM
Enumeration date
12/28/2007
Last updated
12/28/2007
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