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1295014769
DERRICK RAY BACA
ALBUQUERQUE, NM
NPI
1295014769
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223D0001X Dentist, Dental Public Health
(Licence: NM DD3492)
Enumeration Date
2011-08-15
Last Update Date
2011-08-15
Business Address
Dr. DERRICK RAY BACA DDS
5608 ZUNI RD SE
ALBUQUERQUE, NM 87108-2926
Phone number: 505-262-6547
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Mailing Address
Dr. DERRICK RAY BACA DDS
5608 ZUNI RD SE
ALBUQUERQUE, NM 87108-2926
Phone number: 505-262-6547
Copy
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