Individual
VIVIANA A REPENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
5600 COORS BLVD NW, ALBUQUERQUE, NM 87120-1870
(505) 431-9740
Mailing address
9635 BIG ROCK DR NW, ALBUQUERQUE, NM 87114-3027
(720) 289-9202
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DB-2025-0145
NM
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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