| NPI | 1386817765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA B VALDIVIA Owner 505-876-4034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 1637) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |