Organization
RIO GRANDE ORTHODONTICS LLC
Active
Other names
Rio Grande Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DEVAN VEST (OWNER)
(505) 662-4555
Entity
Organization
Contact information
Practice address
3250 TRINITY DR STE A, LOS ALAMOS, NM 87544-2226
(505) 662-4555
Mailing address
3250 TRINITY DR STE A, LOS ALAMOS, NM 87544-2226
(505) 662-4555
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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