| Timothy L Gutierrez Dmd Pa | |
|
1513 Carlisle Blvd Ne Albuquerque NM 87110 | |
| (505) 881-7373 | |
| (505) 881-5096 |
| Full Name | Timothy L Gutierrez Dmd Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1513 Carlisle Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Timothy Lee Gutierrez (ORAL MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 5058817373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy L Gutierrez Dmd Pa 1513 Carlisle Blvd Ne Albuquerque NM 87110 Ph: (505) 881-7373 | Timothy L Gutierrez Dmd Pa 1513 Carlisle Blvd Ne Albuquerque NM 87110 Ph: (505) 881-7373 |
| NPI Number | 1013070911 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013070911 | NPI | - | NPPES |
| 88906 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 1556 (New Mexico) | Primary |
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