| NPI | 1215416524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH C. COOMBS President 575-522-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM 4079) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM 1186) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |