| NPI | 1235359738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANI LEIGH HOSHAW Chairman Of The Board 505-751-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NM DD2176) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NM DD1823) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |