Provider Demographics
NPI:1851643381
Name:VARELA, DEVARAE D (RDH, BS)
Entity Type:Individual
Prefix:MRS
First Name:DEVARAE
Middle Name:D
Last Name:VARELA
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8928 INDIGO SKY TRL SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-2193
Mailing Address - Country:US
Mailing Address - Phone:505-459-3948
Mailing Address - Fax:
Practice Address - Street 1:8928 INDIGO SKY TRL SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-2193
Practice Address - Country:US
Practice Address - Phone:505-459-3948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH2936124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist