| NPI | 1275125221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BARELA Office Manager 505-881-0334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-07-06 |