Provider Demographics
NPI:1538327606
Name:LARRAGOITE, PATRICIO C (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICIO
Middle Name:C
Last Name:LARRAGOITE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-2531
Mailing Address - Country:US
Mailing Address - Phone:505-983-9168
Mailing Address - Fax:
Practice Address - Street 1:812 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2531
Practice Address - Country:US
Practice Address - Phone:505-983-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM 12061223G0001X
NMDD12061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice