| NPI | 1487953790 |
|---|---|
| Doing Business As | ALBUQUERQUE MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MARIO HERREJON-RUIZ Owner Doctor 505-352-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2013-11-18 |