Healthcare Provider Details

I. General information

NPI: 1831055060
Provider Name (Legal Business Name): SAGUARO DENTAL HYGIENE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1098 MECHEM DR
RUIDOSO NM
88345-7044
US

IV. Provider business mailing address

539 SAN SIMON DR
ALAMOGORDO NM
88310-9317
US

V. Phone/Fax

Practice location:
  • Phone: 575-214-7627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: IVAN MUNOZ
Title or Position: OWNER
Credential: RDH
Phone: 575-921-2052