| NPI | 1407944150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GREGORY LOPOUR Owner/President 505-298-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 1996) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2016-04-20 |