| NPI | 1134332596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDUARDO VALDA Owner 505-870-6128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NM dd2150) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NM dd2159) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |