| NPI | 1376953547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R BROWN Operations Manager 575-627-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD2615) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM DD3488) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2024-09-19 |