Desoto, Brock J

Desoto, Brock J is an individual health care provider with primary practice located at 901 Rio Grande Blvd Nw Ste A194 , Albuquerque NM 87104-2054. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Desoto, Brock J can be contacted via phone (505) 582-2950.

Contact Information

Primary practice address
901 Rio Grande Blvd Nw Ste A194 Albuquerque NM 87104-2054
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DD5697 New Mexico

Profile Details

NPI number 1801505607
LBN Legal business name Desoto, Brock J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2022
Last updated Jun 4th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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