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Organization

DENTAL INNOVATIONS OF GALLUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD PAUL BAKER DDS (OWNER)
(505) 863-4457
Entity
Organization

Contact information

Practice address
214 W AZTEC AVE, GALLUP, NM 87301-6302
(505) 863-4457
(505) 722-4310
Mailing address
214 W AZTEC AVE, GALLUP, NM 87301-6302
(505) 863-4457
(505) 722-4310

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
TD0029
NM

Other

Enumeration date
08/14/2012
Last updated
08/14/2012
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