Organization
PROFESSIONAL DENTAL CARE OF NEW MEXICO
Active
Other names
Devine Dental of Las Vegas, Divine Dental of Santa Fe
Organization subpart
No
Provider details
NPI number
Authorized official
CARY LACOUTURE DDS (OWNER)
(303) 521-5701
Entity
Organization
Contact information
Practice address
10233 S PARKER RD STE 107, PARKER, CO 80134-9314
(303) 887-8848
Mailing address
10233 S PARKER RD STE 107, PARKER, CO 80134-9314
(303) 887-8848
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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