DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LEROY BACA, DDS

Active

LEROY BACA, DDS is a Dentist healthcare provider located in T OR C, New Mexico. NPI 1154314177 is currently active in the NPPES registry. Verify at CMS.

Dentist · T OR C, NM

Registration Details

NPI Number
1154314177
Provider Type
Individual
Gender
Male
NPI Issued
Aug 24, 2005 (20.798063623705 yrs)
Last Updated
Jul 8, 2007
License
DD1705 (NM)

Practice Information

Address
1960 N DATE ST
T OR C, NM, 879013701
Browse NM providers · Browse ZIP 87901
Phone
5052673088
Fax
5052671747
Primary Specialty
Dentist
122300000X

Other Dentist Providers in T OR C, NM

Name Credential NPI
MARK WIATT DDS 1801889209
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.