Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 1854 | NM |
NPI | 1003995556 |
---|---|
Provider Name | Dr. Susan M Burns-Sanchez |
First Address | Rio Rancho, NM 87124 |
Second Address | Rio Rancho, NM 87124-1859 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 08/07/2007 |