| NPI | 1477093094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES WHARTON Office Manager 505-892-9893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NM DD4599) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |