| NPI | 1245533439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE J ROGEL President 505-994-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NM DD1538) |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2018-11-29 |