Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Southern Blvd Dental Corp, PA

Organization General Practice Dentistry · NPI 1316963739

Southern Blvd Dental Corp, PA is a General Practice Dentistry in Rio Rancho, New Mexico. Licensed in New Mexico. Registered with an NPI since 2006.

Licensed in
NM
In the registry since
2006
Specialties on file
2
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2716 Southern Blvd SE
Rio Rancho, NM 87124-3741
Phone: (505) 892-8600
Fax: (505) 892-4215
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DD1498 (NM)
General Practice Dentistry Taxonomy 1223G0001X · Licence DD1523 (NM)

Record details

NPI number1316963739
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Martin Goebbel — President/Owner · (505) 892-8600
NPI enumeratedJuly 15, 2006
Last updated in NPPESAugust 22, 2020
Mailing address2716 Southern Blvd Se, Rio Rancho, NM 87124-3741

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