| NPI | 1043371842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DEAN PARKER President 505-988-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NM DD1125) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |