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Individual

JARED BAUERLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2918 HILLRISE DR, LAS CRUCES, NM 88011-4702
(575) 522-2477
Mailing address
2918 HILLRISE DR, LAS CRUCES, NM 88011-4702
(575) 522-2477

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
29230
TX
122300000X
Dentist
DD3986
NM
1223G0001X
General Practice Dentistry
5871 C1
AL
1223P0300X
Periodontics
Primary
DD3986
NM

Other

Enumeration date
07/25/2011
Last updated
09/21/2016
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