Individual
DR. PATRICIA B VALDIVIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1209 BONITA ST, GRANTS, NM 87020-2103
(505) 876-4034
(505) 876-4036
Mailing address
1209 BONITA ST, GRANTS, NM 87020-2103
(505) 285-6937
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD1637
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6583
DORAL DENTAL
NM
01
—
837938
UNITED CONCOORDIA
NM
05
—
89292
—
NM
Enumeration date
11/11/2005
Last updated
07/08/2007
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