| NPI | 1437697125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN CUNNINGHAM Member 575-993-3454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM 2643) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-02-02 |