| NPI | 1386955888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYCE HEINER CEO 575-522-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NM DD3068) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2026-05-27 |