NPI | 1083738918 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN CARROLL CASON President 505-434-0470 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 1227) |
Enumeration Date | 2007-03-17 |
Last Update Date | 2020-08-22 |