| NPI | 1518351790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYCE HEINER Owner/Surgeon 575-522-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NM DD3068) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2015-03-25 |