LEROY BACA

T OR C, NM
NPI1154314177
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: NM  DD1705)
Enumeration Date2005-08-24
Last Update Date2007-07-08
Business Address
-- LEROY BACA DDS
1960 N DATE ST
T OR C, NM 87901-3701
Phone number: 505-267-3088
Mailing Address
-- LEROY BACA DDS
255 HWY 187 P.O BOX 370
HATCH, NM 87937-0370
Phone number: 505-267-3088
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