| NPI | 1376816983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE LEE Owner/Dentist 505-332-8025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD3442) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |