| NPI | 1235681057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINDY RILEY Office Manager 505-892-8600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 1523) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |