Individual
WENDY DIMMETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1214 NATIONAL AVE, LAS VEGAS, NM 87701-4033
(505) 425-7340
(505) 425-7680
Mailing address
1214 NATIONAL AVE, LAS VEGAS, NM 87701-4033
(505) 425-7340
(505) 425-7680
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
96227
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L5334
—
NM
Enumeration date
08/02/2006
Last updated
07/08/2007
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