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General NPI Number Information
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NPI Number | 1164541272
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Entity Type | Organization
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Legal Business Name | CARING DENTAL CENTER PC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 824 HIGHWAY 60
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City | SOCORRO
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State | NM
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Zip | 87801
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Country | US
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Telephone | 505-835-2342
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Fax | 505-835-2207
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Provider Business Mailing Address
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Address Line | PO BOX 124
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City | SOCORRO
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State | NM
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Zip | 87801-0124
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Country | US
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Telephone | 505-835-2342
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Fax | 505-835-2207
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Authorized Official
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Title or Position | PRESIDENT OWNER DENTIST
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Name | DR. MARIAN T LUCERO
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Credential | DDS
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Telephone | 505-835-2342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1552
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License Number State | NM
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