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1205203460
COREY BACA
ALBUQUERQUE, NM
NPI
1205203460
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: NM DH3860)
Enumeration Date
2015-08-24
Last Update Date
2015-08-24
Business Address
-- COREY BACA RDH
1710 WYOMING BLVD NE
ALBUQUERQUE, NM 87112-3855
Phone number: 505-299-9122
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Mailing Address
-- COREY BACA RDH
1710 WYOMING BLVD NE
ALBUQUERQUE, NM 87112-3855
Phone number: 505-299-9122
Copy
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