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Contact Information

DAVINA R DETRIK, DDS
2 CALLE MEDICO STE 3
SANTA FE, NM87505-4785
 Phone: 505-303-1974
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for DAVINA R DETRIK · (Female)

NPI Number 1457793416
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 07/19/2013
Last updated 02/10/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • NM License # DD3923
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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