Individual
TANYA SUE MAESTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
510 E LISA DR, CHAPARRAL, NM 88081-7809
(575) 824-0128
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
37400
TX
1223G0001X
General Practice Dentistry
Primary
DD5147
NM
Other
Enumeration date
07/09/2019
Last updated
08/22/2019
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