| NPI | 1003299173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIAN HAYDEE JAIME President 505-298-0456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NM 1865) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |