Healthcare Provider Details

I. General information

NPI: 1275477028
Provider Name (Legal Business Name): LAGUNA HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BASSWOOD RD
PARAJE NM
87007-1004
US

IV. Provider business mailing address

PO BOX 1407
LAGUNA NM
87026-1407
US

V. Phone/Fax

Practice location:
  • Phone: 505-552-6644
  • Fax: 505-552-1191
Mailing address:
  • Phone: 505-552-6644
  • Fax: 505-552-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CARRIE SARNICKY
Title or Position: CEO
Credential:
Phone: 505-431-0718