Individual
DR. GARY LEE BALZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
305 E WASHINGTON AVE, TUCUMCARI, NM 88401-3873
(505) 461-2400
(505) 461-2400
Mailing address
305 E WASHINGTON AVE, TUCUMCARI, NM 88401-3873
(505) 461-2400
(505) 461-2400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1392
NM
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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