Provider Demographics
NPI:1629841168
Name:NAVARRETTE, REBECCA (RDH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NAVARRETTE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S. 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:LOVING
Mailing Address - State:NM
Mailing Address - Zip Code:88256
Mailing Address - Country:US
Mailing Address - Phone:575-745-3573
Mailing Address - Fax:505-443-8318
Practice Address - Street 1:602 S. 4TH STREET
Practice Address - Street 2:
Practice Address - City:LOVING
Practice Address - State:NM
Practice Address - Zip Code:88256
Practice Address - Country:US
Practice Address - Phone:575-745-3573
Practice Address - Fax:505-443-8318
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH2651124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist