| NPI | 1528315074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD PAUL BAKER Owner 505-863-4457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM TD0029) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |