| NPI | 1154767259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM C GARDNER President 505-828-2669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-05-15 |