Individual
MISS DAISY PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
111 N RAILROAD AVE, ESPANOLA, NM 87532-2627
(505) 587-2809
(505) 753-7218
Mailing address
111 N RAILROAD AVE, ESPANOLA, NM 87532-2627
(505) 587-2809
(505) 753-7218
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH2796
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
321831
PENASCO CLINIC
NM
Enumeration date
09/15/2006
Last updated
07/08/2007
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