Organization
PACHECO FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR MATTHEW PACHECO DMD (CEO)
(623) 383-3839
Entity
Organization
Contact information
Practice address
501 S 2ND ST, TUCUMCARI, NM 88401-2861
(623) 383-3839
Mailing address
501 S 2ND ST, TUCUMCARI, NM 88401-2861
(623) 383-3839
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53034091
—
NM
Enumeration date
06/22/2020
Last updated
06/22/2020
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