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General NPI Number Information
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NPI Number | 1275477028
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Entity Type | Organization
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Legal Business Name | LAGUNA HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 11 BASSWOOD RD
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City | PARAJE
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State | NM
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Zip | 87007-1004
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Country | US
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Telephone | 505-552-6644
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Fax | 505-552-1191
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Provider Business Mailing Address
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Address Line | PO BOX 1407
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City | LAGUNA
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State | NM
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Zip | 87026-1407
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Country | US
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Telephone | 505-552-6644
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Fax | 505-552-1191
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Authorized Official
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Title or Position | CEO
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Name | CARRIE SARNICKY
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Credential |
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Telephone | 505-431-0718
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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 |
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License Number State |
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