De Baca Family Practice Clinic
De Baca Family Practice Clinic is a General Practice Dentistry in Fort Sumner, New Mexico. Registered with an NPI since 2025.
- In the registry since
- 2025
- Specialties on file
- 2
Practice location Address checks out
678 Avenue CFort Sumner, NM 88119
Phone: (575) 355-2417
Fax: (575) 355-2418
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Federally Qualified Health Center (FQHC) (primary) | Taxonomy 261QF0400X |
|---|---|
| General Practice Dentistry | Taxonomy 1223G0001X |
Record details
| NPI number | 1740090729 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | De Baca Family Practice Clinic |
| Authorized official | Lisa Walraven — Ceo · (575) 355-2420 |
| Other names | De Baca Family Practice Clinic/Dental Clinic |
| NPI enumerated | January 10, 2025 |
| Last updated in NPPES | October 14, 2025 |
| Certification date | October 14, 2025 |
| Mailing address | Po Box 349, Fort Sumner, NM 88119-0349 |
Other providers in Fort Sumner
-
Dr. Wil B Pacheco, DDS
546 N 10th St, Fort Sumner, NM 88119 · (575) 355-2414