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 provides 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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