| NPI | 1063557007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE TRUJILLO President/Owner 505-526-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 2171) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2022-07-25 |