Individual
DR. GUSTAVO VASQUEZ SIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1998 N MOTEL BLVD, LAS CRUCES, NM 88007
(575) 541-5941
(575) 541-5048
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D010085
AZ
122300000X
Dentist
Primary
DD5149
NM
Other
Enumeration date
06/26/2018
Last updated
10/22/2019
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