| NPI | 1144701103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL KING Hr & Finance Director 505-263-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NM 03407927000) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2024-01-24 |