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

Westside Pediatric Dentistry

Organization Pediatric Dentistry · NPI 1790808111

Westside Pediatric Dentistry is a Pediatric Dentistry in Rio Rancho, New Mexico. Licensed in New Mexico. Registered with an NPI since 2007.

Licensed in
NM
In the registry since
2007

Practice location Address checks out

1724 Grande Blvd SE
Rio Rancho, NM 87124-1726
Phone: (505) 896-0245
Fax: (505) 892-7579
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence DD1745 (NM)

Record details

NPI number1790808111
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Raymond Broussard — Owner · (505) 896-0245
NPI enumeratedApril 9, 2007
Last updated in NPPESAugust 22, 2020
Mailing address1724 Grande Blvd Se, Rio Rancho, NM 87124-1726

Other providers in Rio Rancho