| NPI | 1396174116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY H MARTIN Dentist 575-521-0127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM 2317) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM 2498) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-11-02 |