Organization
RIO GRANDE SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS EMERSON VICUNA DDS (OWNER)
(505) 877-1113
Entity
Organization
Contact information
Practice address
3200 COORS BLVD NW STE F, ALBUQUERQUE, NM 87120-1176
(505) 877-1113
Mailing address
3200 COORS BLVD NW STE F, ALBUQUERQUE, NM 87120-1176
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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