| NPI | 1134506447 |
|---|---|
| Doing Business As | DESERT RIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JACOB H ROGERS Dentist/Owner 505-890-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD3645) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2015-05-06 |