Organization
SANTA FE COMMUNITY COLLEGE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED OTERO DDS (DENTIST)
(505) 428-1710
Entity
Organization
Contact information
Practice address
6401 S RICHARDS AVE, SANTA FE, NM 87508-4887
(505) 428-1710
(505) 428-1511
Mailing address
6401 S RICHARDS AVE, SANTA FE, NM 87508-4887
(505) 428-1710
(505) 428-1511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68727
—
NM
Enumeration date
02/15/2008
Last updated
02/15/2008
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