Peck, Patricia
Peck, Patricia is an sole proprietor health care provider with primary practice located at 1692 Hospital Dr Bldg B Ste 102, Santa Fe NM 87505-4754. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Peck, Patricia can be contacted via phone (505) 989-9033.Contact Information
Primary practice address
1692 Hospital Dr Bldg B Ste 102
Santa Fe NM 87505-4754
Phone: (505) 989-9033
Fax: (505) 989-9347
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DD1672 | New Mexico |
Profile Details
| NPI number | 1760400998 |
|---|---|
| LBN Legal business name | Peck, Patricia |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Oct 10th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760400998 | NPPES |
| New Mexico | Other | 85-0477522 | DELTA DENTAL INS |
| New Mexico | MEDICAID | 0009630 | DELTA DENTAL INS |
| New Mexico | Other | 1320507 | DELTA DENTAL INS |
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