Individual
JENNIFER GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
608 LA JOYA ST STE B, ESPANOLA, NM 87532-3467
(505) 753-9454
Mailing address
538 N PASEO DE ONATE, ESPANOLA, NM 87532-2618
(505) 753-7218
(505) 747-7396
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DB-2025-0016
NM
Other
Enumeration date
03/19/2025
Last updated
03/19/2025
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