Provider Demographics
NPI:1164541272
Name:CARING DENTAL CENTER PC
Entity Type:Organization
Organization Name:CARING DENTAL CENTER PC
Other - Org Name:DR MARIAN T LUCERO
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:LUCERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-835-2342
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:NM
Mailing Address - Zip Code:87801-0124
Mailing Address - Country:US
Mailing Address - Phone:505-835-2342
Mailing Address - Fax:505-835-2207
Practice Address - Street 1:824 HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801
Practice Address - Country:US
Practice Address - Phone:505-835-2342
Practice Address - Fax:505-835-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM15521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty