NPI | 1356709661 |
---|---|
Entity Type | Organization |
Authorized Contact | RYAN SILL Owner 505-883-5835 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 1484) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD3266) |
Enumeration Date | 2016-02-01 |
Last Update Date | 2023-05-22 |