NPI | 1033400601 |
---|---|
Entity Type | Organization |
Authorized Contact | WILFRED B PACHECO Owner 505-425-6434 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD1606) |
Enumeration Date | 2011-04-29 |
Last Update Date | 2011-04-29 |