De Baca Family Practice Clinic is a renowned Dental office in Santa Rosa, New Mexico. This organization is also known as sub part of De Baca Family Practice Clinic. It is located at 552 Us Hwy 54, Santa Rosa, NM and its contact number is 575-472-2414. The authorized person for De Baca Family Practice Clinic is Lisa Walraven
who is Ceo of the place and their contact number is 575-355-2420.
De Baca Family Practice Clinic Office is a healthcare facility where dedicated dental team composed of licensed professionals, including dentists (DDS or DMD), dental hygienists, dental assistants, and administrative staff (manage appointments, billing, and patient records) provides preventive, diagnostic, and therapeutic oral health services like oral exams and X-rays, fillings, fluoride treatments, teeth cleanings, implants, crowns, bridges, tooth extractions, root canals, and cosmetic procedures such as teeth whitening, braces and veneers to patients through outpatient care.
Complete Profile:
De Baca Family Practice Clinic Office speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | De Baca Family Practice Clinic |
| Specialization: | Dentistry |
| Address: | 552 Us Hwy 54, Santa Rosa,
New Mexico, 88435 |
| Phone: | 575-472-2414 |
| Fax: | 575-472-2416 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this Office are as below. Person's position and contact details are also mentioned below.
| Name: | Lisa Walraven |
| Position: | Ceo |
| Contact Number: | 575-355-2420 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for De Baca Family Practice Clinic Office are as mentioned below.
| NPI Number: | 1962743534 |
| Parent Organization: | De Baca Family Practice Clinic |
| NPI Enumeration Date: | 07 Mar, 2013 |
| NPI Last Update On: | 01 Feb, 2018 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for De Baca Family Practice Clinic are as mentioned below.
| Specialization | License Number | State | Status | |
| Federally Qualified Health Center (FQHC) | | | Primary | |
| Dental | | New Mexico | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the Office such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 84331534 | Medicaid | New Mexico | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | De Baca Family Practice Clinic
Po Box 349,
Fort Sumner, New Mexico |
| Zip: | 88119-0349 |
| Phone Number: | 575-355-2414 |
| Fax Number: | 575-355-7894 |
Patients can reach De Baca Family Practice Clinic at
552 Us Hwy 54, Santa Rosa, New Mexico or can
call to book an appointment on 575-472-2414.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
09 March, 2026.