| NPI | 1013404581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE HANNA Owner 505-273-3220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD4651) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2022-08-22 |