| NPI | 1295080661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GALE JANCSICS Executive Director 505-836-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NM 1503) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NM 2266) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-07-20 |