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General NPI Number Information
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NPI Number | 1649460445
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Entity Type | Individual
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Provider Name | RAMON M ORTIZ DDS
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Gender | Male
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 3045 E UNIVERSITY AVE STE B
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City | LAS CRUCES
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State | NM
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Zip | 88011-9147
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Country | US
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Telephone | 575-521-8720
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Fax |
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Provider Business Mailing Address
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Address Line | 3045 E UNIVERSITY AVE STE B
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City | LAS CRUCES
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State | NM
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Zip | 88011-9147
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Country | US
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Telephone | 575-521-8720
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DD2908
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License Number State | NM
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