NPI | 1164547204 |
---|---|
Doing Business As | DIVINE DENTAL CENTRE |
Entity Type | Organization |
Authorized Contact | ESMAEL ROBERT VALDEZ Owner 505-454-8483 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD2351) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2020-08-22 |