| NPI | 1487794798 |
|---|---|
| Other Name | ON SITE DENTAL, NEW MEXICO |
| Entity Type | Organization |
| Authorized Contact | JAMES J. HISRICH President 928-567-1832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |