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
Phone: (505) 582-2950
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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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