| NPI | 1487880522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER K LAMONT Director 505-750-1379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD3052) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2011-12-29 |