| NPI | 1396979530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY HERBERT EDWARDS President 505-896-9399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD2548) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM DD2550) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2009-05-12 |