| NPI | 1154934818 |
|---|---|
| Doing Business As | SUNDANCE DENTAL OF COUNTRY CLUB |
| Entity Type | Organization |
| Authorized Contact | PAM DRAPER Office Manager 505-326-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-08-24 |