| 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 |