Derrick Baca Dds Llc

LBN: Derrick Baca Dds Llc
Derrick Baca Dds Llc is an health care organization with primary practice located at 1209 Bonita St , Grants NM 87020-2103. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Derrick Baca Dds Llc can be contacted via phone (505) 876-4034, or through Baca, Derrick R via phone (505) 876-4034.

Contact Information

Primary practice address
1209 Bonita St Grants NM 87020-2103
Phone: (505) 876-4034
Fax: (505) 876-4036
Website:
Map and Directions
Authorized official contact:
Name: Baca, Derrick R Doctor of Dental Surgery (DDS)
Phone: (505) 876-4034

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DD3492 New Mexico

Profile Details

NPI number 1902214406
LBN Legal business name Derrick Baca Dds Llc
DBA Doing business as
Authorized official Baca, Derrick R Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 28th, 2014
Last updated Jul 28th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902214406 NPPES
New Mexico MEDICAID 93577389

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