Organization
ACCESS DENTAL OF TRIVIZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL CARRILLO (REGIONAL DIRECTOR)
(469) 242-0743
Entity
Organization
Contact information
Practice address
1748 S TRIVIZ DR, LAS CRUCES, NM 88001-5103
(575) 522-1983
(575) 522-3435
Mailing address
1748 S TRIVIZ DR, LAS CRUCES, NM 88001-5103
(575) 522-1983
(575) 522-3435
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
10/27/2022
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