Individual
MR. BRIAN J TRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDT
Contact information
Practice address
6 CALLE MEDICO, SUITE #5, SANTA FE, NM 87505
(505) 982-4119
(505) 982-0015
Mailing address
6 CALLE MEDICO, SUITE #5, SANTA FE, NM 87505
(505) 982-4119
(505) 982-0015
Taxonomy
Speciality
Code
Description
License number
State
126900000X
Dental Laboratory Technician
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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