| NPI | 1447481775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA A LOPEZ Owner/Hygienist 915-355-7666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NM DH1388) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-04 |