| NPI | 1376844811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER ROUKEMA President 505-836-0322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD3069) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |