| NPI | 1457527368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY L JONES Owner 505-797-3530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NM DD1094) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2011-12-06 |