| NPI | 1255753976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELCEY RIGHTMIRE Adminstrative Assistant 505-564-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD2459) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |