| NPI | 1528172343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDON L. LIEBELT Owner 505-296-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD1301) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |