National Provider Identifier Database

RIO RANCHO ORAL AND MAXILLOFACIAL SURGERY PC
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

RIO RANCHO ORAL AND MAXILLOFACIAL SURGERY PC
1316 JACKIE ROAD SE
SUITE 600
RIO RANCHO, NM87124-6606
Phone: 505-994-4772
Fax: 505-994-1925
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for RIO RANCHO ORAL AND MAXILLOFACIAL SURGERY PC

NPI Number 1245533439
Legal business name
LBN
RIO RANCHO ORAL AND MAXILLOFACIAL SURGERY PC
Authorized official LAURENCE ROGEL - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 12/10/2010
Last updated 11/29/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: DD1538
  • NM Medicaid: 00085266

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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