| NPI | 1104942275 |
|---|---|
| Former Legal Business Name | ENDODONTIC ASSOCIATES, L.L.C. |
| Entity Type | Organization |
| Authorized Contact | TERRYL ANN PETROPOULOS Member 505-881-6902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NM 2728) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |