Provider Demographics
NPI:1639234883
Name:DENTAL HYGIENE CARE OF SANTA FE INC
Entity type:Organization
Organization Name:DENTAL HYGIENE CARE OF SANTA FE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:CORAZZI
Authorized Official - Last Name:GRABOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:COLLABORATIVE PRACTI
Authorized Official - Phone:505-995-0595
Mailing Address - Street 1:2019 GALISTEO STREET
Mailing Address - Street 2:SUITE O-1
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505
Mailing Address - Country:US
Mailing Address - Phone:505-995-0595
Mailing Address - Fax:505-995-0388
Practice Address - Street 1:2019 GALISTEO STREET
Practice Address - Street 2:SUITE O-1
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-995-0595
Practice Address - Fax:505-995-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH246124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty