| NPI | 1083968077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FALON WAISATH President 575-763-9382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD3553) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |