| Deep Blue Dental | |
|
1000 Blue Hole Rd Santa Rosa NM 88435-2533 | |
| (505) 718-6899 | |
| Not Available |
| Full Name | Deep Blue Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1000 Blue Hole Rd, Santa Rosa, New Mexico |
| Authorized Official Name and Position | Raymond Frank Collins (PRESIDENT) |
| Authorized Official Contact | 5057186899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep Blue Dental 1000 Blue Hole Rd Santa Rosa NM 88435-2533 Ph: (505) 718-6899 | Deep Blue Dental 1000 Blue Hole Rd Santa Rosa NM 88435-2533 Ph: (505) 718-6899 |
| NPI Number | 1740484641 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740484641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DD2469 (New Mexico) | Primary |
| 1223G0001X | Dentist - General Practice | DD2208 (New Mexico) | Secondary |
Guadalupe Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 552 Us Hwy 54, Santa Rosa, NM 88435 Phone: 575-472-2414 Fax: 575-472-2416 |